Basic Information
| Provider Information | |||||||||
| NPI: | 1194875856 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | SHANALINGIGWA | ||||||||
| FirstName: | OSWALD | ||||||||
| MiddleName: | ABEL | ||||||||
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| Credential: | MSW, LICSW | ||||||||
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| Mailing Information | |||||||||
| Address1: | 5091 RAINBOW LN | ||||||||
| Address2: | |||||||||
| City: | MOUNDS VIEW | ||||||||
| State: | MN | ||||||||
| PostalCode: | 551124853 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7637177356 | ||||||||
| FaxNumber: | 6512917378 | ||||||||
| Practice Location | |||||||||
| Address1: | 400 SIBLEY ST | ||||||||
| Address2: | SUITE 500 | ||||||||
| City: | SAINT PAUL | ||||||||
| State: | MN | ||||||||
| PostalCode: | 551011941 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6512911979 | ||||||||
| FaxNumber: | 6512917378 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 01/12/2007 | ||||||||
| LastUpdateDate: | 07/08/2007 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 1041C0700X | 15575 | MN | Y | Behavioral Health & Social Service Providers | Social Worker | Clinical |
No ID Information.