Individual
CARLEEN THEISEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
411 3RD ST N, WAITE PARK, MN 56387-1177
(320) 230-2013
(320) 251-4175
Mailing address
254 12TH AVE N, WAITE PARK, MN 56387-1035
(320) 250-0240
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
29939
MN
Other
Enumeration date
12/07/2023
Last updated
12/07/2023
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