AUTUMN MICHELLE PHENOW

FRIDLEY, MN
NPI1154980068
Entity TypeIndividual
GenderFemale
Sole Proprietor ?No
Primary Taxonomy1041C0700X Social Worker, Clinical
(Licence: MN  22651)
Enumeration Date2019-06-13
Last Update Date2019-08-22
Business Address
AUTUMN MICHELLE PHENOW MSW, LICSW
6341 UNIVERSITY AVE NE
FRIDLEY, MN 55432-4946
Phone number: 612-672-6999
Mailing Address
AUTUMN MICHELLE PHENOW MSW, LICSW
2785 WHITE BEAR AVE N STE 403
MAPLEWOOD, MN 55109-1327
Phone number: 651-395-5775