Tara Waldron, LICSW

NPI #1750723573 in Blaine, Minnesota

Provider Information

NPI Number
1750723573
Entity Type
Individual
Name
Tara Waldron, LICSW
Gender
Not Specified
Sole Proprietor
No
Primary Specialty
Social Worker - Clinical
Credential
LICSW
Enumeration Date
Jul 22, 2013
Last Updated
Jul 22, 2013

Practice Location

Address
11870 ULYSSES ST NE
Address 2
STE 200
City
Blaine
ZIP Code
55434-4179
Phone
(763) 482-9598

Specialties & Taxonomy Codes

Specialty
Social Worker - ClinicalClinical

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