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Individual

JOHN R KRUEGER

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
LP, LICSW

Contact information

Practice address
157 ROOSEVELT RD STE 300, SAINT CLOUD, MN 56301-5481
(320) 240-3324
(320) 240-3339
Mailing address
PO BOX 2390, SAINT CLOUD, MN 56302-2390
(320) 650-1544
(320) 650-1528

Taxonomy

Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
LP0553
MN
1041C0700X
Clinical Social Worker
3705
MN

Other

Enumeration date
11/16/2007
Last updated
11/16/2007
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