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Organization

INNER OUTFITTERS, INC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MS. SANDRA MARY KACHER MSW (PSYCHOTHERAPIST)
(612) 874-8608
Entity
Organization

Contact information

Practice address
1409 WILLOW ST, SUITE 200, MINNEAPOLIS, MN 55403-2269
(612) 874-8608
(612) 874-8612
Mailing address
1409 WILLOW ST, SUITE 200, MINNEAPOLIS, MN 55403-2269
(612) 874-8608
(612) 874-8612

Taxonomy

Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
01976
MN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1609932540
NPI INDIVIDUAL NUMBER
MN
Enumeration date
07/12/2010
Last updated
07/12/2010
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