Individual
MR. KYLE GREGORY CLOUTIER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LICSW
Contact information
Practice address
1120 CENTRE POINTE DR STE 100, #100, MENDOTA HEIGHTS, MN 55120-1275
(952) 334-8278
(952) 891-4258
Mailing address
PO BOX 240125, APPLE VALLEY, MN 55124-0125
(952) 334-8278
(952) 891-4258
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
13976
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
114510
HEALTH PARTNERS
MN
01
—
505K6CL
BLUE CROSS BLUE SHIELD
MN
01
—
556368
VALUE OPTIONS
NY
Enumeration date
01/19/2007
Last updated
07/24/2020
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