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General NPI Number Information
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NPI Number | 1285870030
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Entity Type | Individual
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Provider Name | ELIZABETH M ANEZ LCSW, LICSW
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Gender | Female
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Dates
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Enumeration Date | 12/29/2008
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Last Update Date | 06/27/2018
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Provider Practice Location Address
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Address Line | 1385 MENDOTA HEIGHTS RD STE 200
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City | MENDOTA HEIGHTS
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State | MN
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Zip | 55120
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Country | US
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Telephone | 651-379-9800
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Fax | 651-405-0358
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Provider Business Mailing Address
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Address Line | 154 BRIDGEWATER TRL
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City | HUDSON
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State | WI
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Zip | 54016-7778
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Country | US
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Telephone | 715-497-6678
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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 | 18477
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License Number State | MN
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