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NPI Code Detail

MEDICARE: MS. MYRNA ANN KIEL LICSW

MEDICARE: MS. MYRNA ANN KIEL 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 Worker09249MN

General Provider Information

NPI Number : 1780917658
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. MYRNA ANN KIEL LICSW
Provider Business Mailing Address
First Line : 14955 GALAXIE AVE
Second Line :
City : APPLE VALLEY
State : MN
Zip : 55124-4519
Country : US
Telephone Number : 952-891-7320
Fax Number :
Provider Business Practice Location Address
First Line : 14955 GALAXIE AVE
Second Line :
City : APPLE VALLEY
State : MN
Zip : 55124-4519
Country : US
Telephone Number : 952-891-7320
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/10/2009
Last Update Date : 02/08/2013

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Directions to “ MS. MYRNA ANN KIEL LICSW” Practice Location

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