Individual
AMANDA WANNARKA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LICSW
Contact information
Practice address
199 COON RAPIDS BLVD NW STE 208, COON RAPIDS, MN 55433-5860
(612) 440-1899
Mailing address
2906 129TH AVE NW, COON RAPIDS, MN 55448-2384
(612) 309-2691
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
23382
MN
Other
Enumeration date
11/16/2016
Last updated
11/03/2022
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