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NPI Code Detail

MEDICARE: EMILY JEAN KALBOW LGSW,MSW

MEDICARE: EMILY JEAN KALBOW LGSW,MSW
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 Worker

General Provider Information

NPI Number : 1477124196
Entity Type Code : Individual
Provider Name (Legal Business Name) : EMILY JEAN KALBOW LGSW,MSW
Provider Business Mailing Address
First Line : 255 W 96TH ST APT 3E
Second Line :
City : BLOOMINGTON
State : MN
Zip : 55420-4338
Country : US
Telephone Number : 763-516-2711
Fax Number :
Provider Business Practice Location Address
First Line : 8646 EAGLE CREEK CIR STE 213
Second Line :
City : SAVAGE
State : MN
Zip : 55378-1574
Country : US
Telephone Number : 952-583-1055
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/03/2021
Last Update Date : 08/16/2022

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