Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1041C0700X | Clinical Social Worker | 23281 | MN |
NPI | 1003264573 |
---|---|
Provider Name | Sara Vogelpohl |
First Address | Saint Paul, MN 55116-1008 |
Second Address | Oakdale, MN 55128-3937 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 25/05/2016 |
Last Update Date | 25/05/2016 |