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General NPI Number Information
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NPI Number | 1376663963
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Entity Type | Individual
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Provider Name | ANASTASIA LOUISE CYPTAR LICSW
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Gender | Female
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Dates
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Enumeration Date | 03/29/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 317 YORK AVE
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City | SAINT PAUL
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State | MN
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Zip | 55101-4039
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Country | US
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Telephone | 651-774-0011
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Fax | 651-774-0606
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Provider Business Mailing Address
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Address Line | 13220 GRAND OAK CT
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City | APPLE VALLEY
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State | MN
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Zip | 55124-8756
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Country | US
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Telephone | 952-953-3524
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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 | 12190
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License Number State | MN
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