Individual
CARLY RAE MANDERFELD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LGSW
Contact information
Practice address
7601 WAYZATA BLVD, ST LOUIS PARK, MN 55426-1623
(507) 217-0049
Mailing address
1241 E MAIN ST, MANKATO, MN 56001-5080
(507) 217-0049
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
32524
MN
Other
Enumeration date
08/23/2023
Last updated
08/23/2023
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