Individual
KATHRYN ELISON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LICSW
Contact information
Practice address
2512 S 7TH ST, PEDIATRIC SPECIALTY CLINIC, MINNEAPOLIS, MN 55454-1404
(612) 365-6777
(612) 365-8001
Mailing address
717 DELAWARE ST SE, MAIL CODE 1932, MINNEAPOLIS, MN 55414-2959
(704) 707-6681
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
23063
MN
Other
Enumeration date
03/24/2016
Last updated
03/24/2016
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