Most Relevant Information
Provider Data
NPI Number: | 1003120395 |
Provider Name: | IVA JOAN STAUFFER LICSW |
Entity Type: | Individual |
Taxonomy Code: | 1041C0700X |
Specialty: | Social Worker |
License Number: | 19293 |
Most Important Dates
Enumeration Date: | 07/29/2010 |
Last Updated: | 07/29/2010 |
Provider Practice Location
5905 GOLDEN VALLEY RD
SUITE 100
GOLDEN VALLEY
MN
554224463
Practice Location Phone/Fax
Phone: | 6126177802 |
Fax: | 6123316772 |
Provider Mailing Location
2021 E HENNEPIN AVE
SUITE 200
MINNEAPOLIS
MN
554132700
Provider Mailing Phone/Fax
Phone: | 6126177802 |
Fax: | 6123316772 |