Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 104100000X | Social Worker |
NPI | 1003076068 |
---|---|
Provider Name | Ms. Caitlin Maurine Walseth |
First Address | Minneapolis, MN 55417-2309 |
Second Address | Minneapolis, MN 55417-2309 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 12/06/2008 |
Last Update Date | 20/11/2010 |