Individual
CASIE IWATA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MSW, LICW
Contact information
Practice address
2136 FORD PKWY # 5481, SAINT PAUL, MN 55116-2850
(612) 466-0315
Mailing address
2136 FORD PKWY # 5481, SAINT PAUL, MN 55116-2850
(612) 466-0315
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
22617
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1740784859
—
MN
Enumeration date
03/22/2018
Last updated
12/20/2022
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