Mary Rose Nettleton, LICSW

NPI #1073611729 in Fridley, Minnesota

Provider Information

NPI Number: 1073611729
Entity Type: Individual
Name: Mary Rose Nettleton, LICSW
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Social Worker
Credential: LICSW
Enumeration Date: Sep 20, 2006
Last Updated: Jul 8, 2007

Practice Location

Address: 7362 UNIVERSITY AVE NE
Address 2: SUITE 209
City: Fridley
State: Minnesota
ZIP Code: 55432-3142
Phone: (612) 825-4407

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Social Worker	104100000X	Primary

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