Individual
ELIZABETH RUSKIN SHANKLIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LICSW
Contact information
Practice address
1930 COON RAPIDS BLVD NW, COON RAPIDS, MN 55433-4708
(763) 427-7964
(763) 427-7976
Mailing address
1930 COON RAPIDS BLVD NW, COON RAPIDS, MN 55433-4708
(763) 427-7964
(763) 427-7976
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
11123
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
052318600
—
MN
01
—
1013871
PREFERRED ONE
MN
01
—
119993
U CARE
MN
01
—
584G2SH
BCBS
MN
01
—
6270885
UBH
MN
01
—
HP70711
HEALTH PARTNERS
MN
Enumeration date
09/20/2006
Last updated
12/10/2008
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