Individual
DEBRA SUZANNE LEAVITT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LICSW
Contact information
Practice address
8401 WAYZATA BLVD STE 370, GOLDEN VALLEY, MN 55426-1379
(763) 544-1006
(763) 544-1008
Mailing address
8401 WAYZATA BLVD STE 370, GOLDEN VALLEY, MN 55426-1379
(763) 544-1006
(763) 544-1008
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
17629
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
17629
LICSW STATE BOARD
MN
Enumeration date
02/09/2009
Last updated
02/09/2009
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