Individual
JONATHAN WALTERS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
6550 YORK AVE S STE 417, EDINA, MN 55435-2336
(952) 426-3034
Mailing address
2813 VIRGINIA AVE S, ST LOUIS PARK, MN 55426-3033
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
29041
MN
Other
Enumeration date
01/08/2025
Last updated
02/11/2025
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