Doctor Name: | SUSAN KREULEN |
NPI Number: | 1467691881 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | LICSW |
License Number: | 20526 |
Business Practice Address: | 20 Lake St N Suite 210 Forest Lake, MN - 550252523 |
Business Phone Number: | 6126721514 |
Business Fax Number: | 6514644847 |
Mailing Address: | 20 Lake St N, Suite 210 FOREST LAKE |
State: | MN |
Postal Code: | 550252523 |
Phone Number: | 6126721514 |
Fax Number: | 6514644847 |
NPI Enumeration Date: | 02/09/2009 |
NPI Last Update Date: | 08/12/2013 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 1041C0700X |
License Number: | 20526 |
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 |