Individual
SHARON LISA LETIZIO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MSW LICSW
Contact information
Practice address
540 E 1ST ST, WACONIA, MN 55387-1601
(952) 442-4437
(952) 442-3084
Mailing address
540 E 1ST ST, WACONIA, MN 55387-1601
(952) 442-4437
(952) 442-3084
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
09412
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1023604
PREFERRED ONE
MN
01
—
6295013
UBH-MEDICA
MN
05
—
802957100
—
MN
01
—
88D04LE
BCBS
MN
01
—
HP30776
HEALTH PARTNERS
MN
Enumeration date
08/10/2005
Last updated
02/19/2014
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