Diane Rae Grinnell, LICSW
Social Worker, Clinical in Eagan, MN. Individual provider (NPI-1).
NPI number1649366808
StatusActive
Last updated in NPPESMar 21, 2018
Details
- NPI
- 1649366808
- Entity type
- Individual (NPI-1)
- Name
- Diane Rae Grinnell
- Credential
- LICSW
- Sex
- Female
- Sole proprietor
- Yes
- Enumeration date
- Oct 5, 2006
- Last updated
- Mar 21, 2018
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 1041C0700X | Social Worker, Clinical | 8942 | MN | Yes |
Practice location
3450 Oleary LnEagan, MN 55123-2340
Phone 651-454-0114 · Fax 651-454-3492
Mailing address
12773 Ethelton WayApple Valley, MN 55124-7802
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All 80 Clinical Social Worker providers in Eagan · All 2,108 providers in Eagan
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