| Kiel Walters Licsw Pc | |
|
5200 Willson Rd Ste 210 Edina MN 55424-1343 | |
| (612) 787-2475 | |
| Not Available |
| Full Name | Kiel Walters Licsw Pc |
|---|---|
| Speciality | Social Worker - Clinical |
| Location | 5200 Willson Rd Ste 210, Edina, Minnesota |
| Authorized Official Name and Position | Kiel Walters (OWNER) |
| Authorized Official Contact | 6127872475 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Kiel Walters Licsw Pc 5200 Willson Rd Ste 210 Edina MN 55424-1343 Ph: (612) 787-2475 | Kiel Walters Licsw Pc 5200 Willson Rd Ste 210 Edina MN 55424-1343 Ph: (612) 787-2475 |
| NPI Number | 1396309696 |
|---|---|
| Provider Enumeration Date | 04/23/2019 |
| Last Update Date | 01/08/2020 |
| Certification Date | 01/08/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1396309696 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
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