Healthcare Provider Details

I. General information

NPI: 1518919935
Provider Name (Legal Business Name): LAUREL LEE KLAWITTER LICSW
Entity Type: Individual
Gender: Female
Sole Proprietor: X

Provider Other Name: LAUREL LEE OLSON

II. Dates (important events)

Enumeration Date: 05/16/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1095 HIGHWAY 15 SOUTH HUTCHINSON AREA HEALTH CARE
HUTCHINSON MN
55350
US

IV. Provider business mailing address

1095 HIGHWAY 15 SOUTH HUTCHINSON AREA HEALTH CARE
HUTCHINSON MN
55350
US

V. Phone/Fax

Practice location:
  • Phone: 320-234-4610
  • Fax:
Mailing address:
  • Phone: 320-234-4610
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number222
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: