Organization
ELIZABETH HUBBARD BRADY, MSW, LICSW, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ELIZABETH HUBBARD BRADY LICSW (OWNER)
(651) 523-8800
Entity
Organization
Contact information
Practice address
1619 DAYTON AVE STE 110, SAINT PAUL, MN 55104-6276
(651) 523-8800
(651) 523-8811
Mailing address
1619 DAYTON AVE STE 110, SAINT PAUL, MN 55104-6276
(651) 523-8800
(651) 523-8811
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
09797
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
55G76BR
BLUE CROSS/BLUE SHIELD
MN
Enumeration date
02/26/2008
Last updated
02/26/2008
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