Individual
EMILY ANN BASTIAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
L.I.C.S.W.
Contact information
Practice address
1825 CHICAGO AVE, MINNEAPOLIS, MN 55404-1939
(612) 752-8236
Mailing address
1825 CHICAGO AVE, MINNEAPOLIS, MN 55404-1939
(612) 752-8236
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
18128
MN
Other
Enumeration date
04/06/2011
Last updated
07/18/2024
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