Mary Joanne Ethen LICSW

NPI 1619138633 - Social Worker - 1041C0700X

NPI Details
NPI 1619138633
Gender Female
Enumeration Date 06/23/2008
Last Updated 06/23/2008
Entity Type Individual
Active Over 8 years ago
Practice Location
69 EXCHANGE ST W
SAINT PAUL MN, 55102-1004, US
Phone (651) 326-3675
Fax (651) 232-3494
Business Location
361 COLLEEN DR
VADNAIS HEIGHTS MN, 55127-7086, US
Phone (651) 326-3675
Fax (651) 232-3494
Toxanomy
Taxonomy Code 1041C0700X
License State Minnesota
License Number 17361
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According to our database, Ms. Mary Joanne Ethen LICSW NPI is 1619138633, taxonomy code is 1041C0700X and license number is 17361, license state is located at Minnesota. Mary Joanne Ethen LICSW physically located at 69 Exchange St W, Saint Paul MN, 55102-1004. NPI Number Mary Joanne Ethen LICSW has the Individual type.

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1619138633 NPI number is provided on an as is basis without warranty of any kind. 1619138633 is maintained by the National Plan & Provider Enumeration System. The contents of Mary Joanne Ethen LICSW are for informational purposes only.