Doctor Name: | NANCY K KUJAWA |
NPI Number: | 1114194719 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | LSW LADC |
License Number: | 17876 |
Business Practice Address: | 1111 Gateway Dr Ne East Grand Forks, MN - 567212620 |
Business Phone Number: | 2187930420 |
Business Fax Number: | |
Mailing Address: | 1111 Gateway Dr Ne, EAST GRAND FORKS |
State: | MN |
Postal Code: | 567212620 |
Phone Number: | 2187930420 |
Fax Number: | |
NPI Enumeration Date: | 05/13/2008 |
NPI Last Update Date: | 07/14/2014 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 1041C0700X |
License Number: | 17876 |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | MN |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Social Worker |
Taxonomy Specialization: | Clinical |
Taxonomy Definition: | A social worker who holds a master |