Healthcare Provider Details

I. General information

NPI: 1417008095
Provider Name (Legal Business Name): KATHERINE GRACE VREEMAN MSSW, LICSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: KATHERINE HARRIES MUELLNER MSSW, LICSW

II. Dates (important events)

Enumeration Date: 01/12/2007
Last Update Date: 07/09/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6005 SALEM RD SW
ROCHESTER MN
55902-8825
US

IV. Provider business mailing address

6005 SALEM RD SW
ROCHESTER MN
55902-8825
US

V. Phone/Fax

Practice location:
  • Phone: 507-281-3033
  • Fax:
Mailing address:
  • Phone: 507-281-3033
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number4226
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: