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General NPI Number Information
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NPI Number | 1124383799
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Entity Type | Individual
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Provider Name | CHRISTINE DUMKE M.S.W. L.G.S.W.
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Gender | Female
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Dates
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Enumeration Date | 07/10/2012
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Last Update Date | 07/10/2012
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Provider Practice Location Address
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Address Line | 7260 UNIVERSITY AVE NE SUITE 235
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City | FRIDLEY
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State | MN
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Zip | 55432-3126
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Country | US
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Telephone | 763-572-2605
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Fax |
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Provider Business Mailing Address
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Address Line | 6661 PINE ST
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City | CIRCLE PINES
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State | MN
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Zip | 55014-2115
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Country | US
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Telephone |
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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 | 21267
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License Number State | MN
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