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NPI Code Detail

MEDICARE: SALEHA ERDMANN MSW, LICSW

MEDICARE: SALEHA ERDMANN MSW, 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 Worker22666MN

General Provider Information

NPI Number : 1669111613
Entity Type Code : Individual
Provider Name (Legal Business Name) : SALEHA ERDMANN MSW, LICSW
Provider Business Mailing Address
First Line : 3120 18TH AVE S
Second Line :
City : MINNEAPOLIS
State : MN
Zip : 55407-1825
Country : US
Telephone Number : 612-462-9331
Fax Number :
Provider Business Practice Location Address
First Line : 3120 18TH AVE S
Second Line :
City : MINNEAPOLIS
State : MN
Zip : 55407-1825
Country : US
Telephone Number : 612-462-9331
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/28/2022
Last Update Date : 05/28/2022

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