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General NPI Number Information
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NPI Number | 1063091510
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Entity Type | Individual
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Provider Name | ELIN AMUNDSON LICSW
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Gender | Female
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Dates
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Enumeration Date | 04/02/2021
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Last Update Date | 09/08/2022
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Provider Practice Location Address
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Address Line | 3250 RICE ST
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City | SAINT PAUL
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State | MN
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Zip | 55126-3080
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Country | US
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Telephone | 507-525-1964
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Fax |
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Provider Business Mailing Address
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Address Line | 6417 PENN AVE S STE 8 IPMB 1213
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City | MINNEAPOLIS
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State | MN
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Zip | 55423-1196
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Country | US
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Telephone | 507-525-1964
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number |
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License Number State |
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