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General NPI Number Information
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NPI Number | 1396152385
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Entity Type | Organization
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Legal Business Name | ANNE DELMONT, LLC
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Dates
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Enumeration Date | 07/22/2014
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Last Update Date | 07/22/2014
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Provider Practice Location Address
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Address Line | 366 SELBY AVE SUITE 200
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City | SAINT PAUL
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State | MN
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Zip | 55102-1880
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Country | US
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Telephone | 612-867-1215
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Fax | 651-224-4353
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Provider Business Mailing Address
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Address Line | 366 SELBY AVE SUITE 200
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City | SAINT PAUL
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State | MN
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Zip | 55102-1880
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Country | US
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Telephone | 612-867-1215
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Fax | 651-224-4353
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Authorized Official
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Title or Position | PSYCHOTHERAPIST
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Name | ANNE DELMONT
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Credential | MSW, LICSW
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Telephone | 612-867-1215
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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 | 16713
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License Number State | MN
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