Individual
LINDA LEE PAGENKOPF
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
L.I.C.S.W.
Contact information
Practice address
2903 15TH ST S, MOORHEAD, MN 56560
(218) 331-2032
Mailing address
2903 15TH ST S, MOORHEAD, MN 56560-5111
(218) 331-2032
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
14352
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
14352
BOARD OF SOCIAL WORK
MN
Enumeration date
01/09/2009
Last updated
08/28/2018
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