Individual
MARYBETH KIMBALL GAGE EHLERT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MSW, LICSW
Contact information
Practice address
12301 WHITEWATER DR STE 101, MINNETONKA, MN 55343-4157
(612) 501-6279
Mailing address
12301 WHITEWATER DR STE 101, MINNETONKA, MN 55343-4157
(952) 999-6097
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
27432
MN
Other
Enumeration date
02/13/2020
Last updated
08/02/2022
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