MEDICARE: SARA KUEHN

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	104100000X	Social Worker	10637	MN

General Provider Information

NPI Number	:	1124446547
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SARA KUEHN

Provider Business Mailing Address
First Line	:	6328 PENN AVE S
Second Line	:
City	:	RICHFIELD
State	:	MN
Zip	:	55423-1139
Country	:	US
Telephone Number	:	612-767-5160
Fax Number	:	612-767-5176

Provider Business Practice Location Address
First Line	:	6328 PENN AVE S
Second Line	:
City	:	RICHFIELD
State	:	MN
Zip	:	55423-1139
Country	:	US
Telephone Number	:	612-767-5160
Fax Number	:	612-767-5176

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/02/2014
Last Update Date	:	04/02/2014

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Directions to “ SARA KUEHN ” Practice Location

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