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General NPI Number Information
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NPI Number | 1649366659
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Entity Type | Individual
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Provider Name | DAVID VALENTINE PERRIN LICSW
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Gender | Male
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Dates
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Enumeration Date | 10/05/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 1783 WOODLANE DR
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City | WOODBURY
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State | MN
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Zip | 55125-2910
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Country | US
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Telephone | 651-730-7074
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Fax |
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Provider Business Mailing Address
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Address Line | 10823 32ND ST N
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City | LAKE ELMO
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State | MN
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Zip | 55042-9716
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Country | US
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Telephone | 651-770-7137
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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 | LICSW1384
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License Number State | MN
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