Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 104100000X | Social Worker | 11772 | MN |
NPI | 1003090333 |
---|---|
Provider Name | Cynthia Byron Guddal |
First Address | Golden Valley, MN 55422-4249 |
Second Address | Golden Valley, MN 55422-4249 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 21/12/2007 |
Last Update Date | 21/12/2007 |