Basic Information
Provider Information
NPI: 1962634253
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: SAHR-WOLTMAN
FirstName: ANN
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential: MSW/LISCW
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 1100 GLENWOOD AVE
Address2:  
City: MINNEAPOLIS
State: MN
PostalCode: 554051430
CountryCode: US
TelephoneNumber: 6128711454
FaxNumber: 6128711505
Practice Location
Address1: 1100 GLENWOOD AVE
Address2:  
City: MINNEAPOLIS
State: MN
PostalCode: 55405
CountryCode: US
TelephoneNumber: 6128711454
FaxNumber: 6128711505
Other Information
ProviderEnumerationDate: 08/20/2009
LastUpdateDate: 07/18/2018
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
1041C0700X15406MNY Behavioral Health & Social Service ProvidersSocial WorkerClinical

No ID Information.


Home