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NPI Code Detail

MEDICARE: ANNMARIE KAY FLOREST LICSW

MEDICARE: ANNMARIE KAY FLOREST LICSW
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
11041C0700XClinical Social Worker16526MN

General Provider Information

NPI Number : 1275890980
Entity Type Code : Individual
Provider Name (Legal Business Name) : ANNMARIE KAY FLOREST LICSW
Provider Business Mailing Address
First Line : 3729 SNELLING AVE APT 204
Second Line :
City : MINNEAPOLIS
State : MN
Zip : 55406-2608
Country : US
Telephone Number : 612-799-6641
Fax Number :
Provider Business Practice Location Address
First Line : 2120 PARK AVE
Second Line :
City : MINNEAPOLIS
State : MN
Zip : 55404-3378
Country : US
Telephone Number : 612-872-2000
Fax Number : 612-871-1375
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/19/2012
Last Update Date : 04/12/2018

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Directions to “ ANNMARIE KAY FLOREST LICSW” Practice Location

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