Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1041C0700X | Clinical Social Worker | 19531 | MN |
NPI | 1003173907 |
---|---|
Provider Name | Melissa Ann Winkler |
First Address | Duluth, MN 55807-1563 |
Second Address | Duluth, MN 55807-1563 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 16/04/2012 |
Last Update Date | 06/04/2018 |