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Individual

MARTHA JEAN OSTERBERG

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
L.I.C.S.W.

Contact information

Practice address
621 W LAKE ST, SUITE 210, MINNEAPOLIS, MN 55408-2949
(612) 822-3417
Mailing address
621 W LAKE ST, SUITE 210, MINNEAPOLIS, MN 55408-2949
(612) 822-3417

Taxonomy

Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
10825
MN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
16D66OS
BLUE CROSS&BLUE SHIELD
MN
Enumeration date
01/20/2007
Last updated
07/08/2007
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