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Individual

INGER LISE INGVARTSEN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
ASW

Contact information

Practice address
183 PYTHIAN RD, SANTA ROSA, CA 95409-6518
(707) 571-2215
(707) 526-9672
Mailing address
1813 BELLA VISTA WAY, SANTA ROSA, CA 95403-5700
(707) 576-1476
(707) 526-9672

Taxonomy

Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
14632
CA

Other

Enumeration date
03/15/2007
Last updated
07/08/2007
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