Lyle Gene Elenkiwich, MSW, LICSW

NPI #1649461245 in Ham Lake, Minnesota

Provider Information

NPI Number
1649461245
Entity Type
Individual
Name
Lyle Gene Elenkiwich, MSW, LICSW
Gender
Not Specified
Sole Proprietor
Yes
Primary Specialty
Social Worker - Clinical
Credential
MSW, LICSW
Enumeration Date
Aug 8, 2007
Last Updated
Aug 8, 2007

Practice Location

Address
2311 146TH AVE NE
ZIP Code
55304-6408
Phone
(763) 242-9240

Specialties & Taxonomy Codes

Specialty
Social Worker - ClinicalClinical

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