Doctor Name: | SUSAN MARIE LESKELA |
NPI Number: | 1144580655 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | MSW,LICSW |
License Number: | 4410 |
Business Practice Address: | 45 West 10th Street St Paul, MN - 55101 |
Business Phone Number: | 6512323338 |
Business Fax Number: | |
Mailing Address: | 2885 Knox Ave S, 307 MINNEAPOLIS |
State: | MN |
Postal Code: | 554081852 |
Phone Number: | 6123961420 |
Fax Number: | |
NPI Enumeration Date: | 05/18/2012 |
NPI Last Update Date: | 05/18/2012 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 1041C0700X |
License Number: | 4410 |
Healthcare Provider Taxonomy: (Secondary) | Y |
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 |