Individual
JEANNE MARTHA ABICHT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MSW LICSW
Contact information
Practice address
12918 63RD AVE N, MAPLE GROVE, MN 55369-6001
(763) 219-9966
Mailing address
12918 63RD AVE N, MAPLE GROVE, MN 55369-6001
(763) 210-9966
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
23823
MN
Other
Enumeration date
11/12/2018
Last updated
05/02/2019
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