Doctor Name: | CHRISTINE MARIE MANN |
NPI Number: | 1295184562 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | MSW, LICSW, LADC |
License Number: | 21451 |
Business Practice Address: | 117 S Spring St Luverne, MN - 561561916 |
Business Phone Number: | 5072839511 |
Business Fax Number: | 5072839514 |
Mailing Address: | 117 S Spring St, LUVERNE |
State: | MN |
Postal Code: | 561561916 |
Phone Number: | 5072839511 |
Fax Number: | 5072839514 |
NPI Enumeration Date: | 06/08/2016 |
NPI Last Update Date: | 06/08/2016 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 1041C0700X |
License Number: | 21451 |
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 |