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NPI Code Detail

MEDICARE: SUSAN MARY WINSLOW MSW

MEDICARE:   SUSAN MARY WINSLOW  MSW
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
11041C0700XClinical Social Worker08156MN

General Provider Information

NPI Number : 1467539726
Entity Type Code : Individual
Provider Name (Legal Business Name) : SUSAN MARY WINSLOW MSW
Provider Business Mailing Address
First Line : 5125 W 110TH ST
Second Line :
City : BLOOMINGTON
State : MN
Zip : 55437-3326
Country : US
Telephone Number : 952-888-0188
Fax Number :
Provider Business Practice Location Address
First Line : 4432 CHICAGO AVE
Second Line :
City : MINNEAPOLIS
State : MN
Zip : 55407-3519
Country : US
Telephone Number : 612-870-2441
Fax Number : 612-870-2403
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/01/2006
Last Update Date : 07/08/2007

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Directions to “ SUSAN MARY WINSLOW MSW” Practice Location

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