Individual
JILL MICHELE STIBER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MSSW, LICSW, BCD
Contact information
Practice address
13100 WAYZATA BLVD, SUITE 400, MINNETONKA, MN 55305-1802
(952) 546-0616
(952) 573-1778
Mailing address
4006 BASSWOOD RD, ST LOUIS PARK, MN 55416-3845
(952) 929-1398
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
17096
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
508R3ST 3G377LA SW
BLUE CROSS BLUE SHIELD
MN
01
—
876408500
MEDICAL ASSISTANCE
MN
01
—
HP52398
HEALTH PARTNERS
MN
Enumeration date
12/01/2006
Last updated
07/08/2007
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