| Kathleen Van Wie Lcsw, Inc | |
|
775 Sunrise Ave Ste 120 Roseville CA 95661-4527 | |
| (916) 786-3740 | |
| (916) 773-0965 |
| Full Name | Kathleen Van Wie Lcsw, Inc |
|---|---|
| Speciality | Social Worker - Clinical |
| Location | 775 Sunrise Ave Ste 120, Roseville, California |
| Authorized Official Name and Position | Kathleen Van Wie (DIRECTOR) |
| Authorized Official Contact | 9167863740 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Kathleen Van Wie Lcsw, Inc 775 Sunrise Ave Ste 120 Roseville CA 95661-4527 Ph: () - | Kathleen Van Wie Lcsw, Inc 775 Sunrise Ave Ste 120 Roseville CA 95661-4527 Ph: (916) 786-3740 |
| NPI Number | 1174765630 |
|---|---|
| Provider Enumeration Date | 03/30/2009 |
| Last Update Date | 03/30/2009 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1174765630 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | LB009283 (California) | Primary |
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