Mary Ellen Bigham, MSW, LICSW
Social Worker, Clinical in Maple Grove, MN. Individual provider (NPI-1).
NPI number1245554161
StatusActive
Last updated in NPPESOct 27, 2016
Details
- NPI
- 1245554161
- Entity type
- Individual (NPI-1)
- Name
- Mary Ellen Bigham
- Credential
- MSW, LICSW
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Mar 22, 2010
- Last updated
- Oct 27, 2016
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 1041C0700X | Social Worker, Clinical | – | MN | Yes |
Practice location
13603 80th Circle NorthMaple Grove, MN 55369
Phone 763-416-1489 · Fax 763-416-3957
Mailing address
1900 Silver Lake Rd NwSuite 110
New Brighton, MN 55112-1786
Phone 651-379-1764 · Fax 651-379-1738
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