Basic Information
| Provider Information | |||||||||
| NPI: | 1982932802 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | BRITTON | ||||||||
| FirstName: | JONI | ||||||||
| MiddleName: | KARLA | ||||||||
| NamePrefix: | |||||||||
| NameSuffix: | |||||||||
| Credential: | MA ED, LICSW | ||||||||
| OtherOrganizationName: | |||||||||
| OtherOrganizationType: | |||||||||
| OtherLastName: | ANDRASHKO | ||||||||
| OtherFirstName: | JONI | ||||||||
| OtherMiddleName: | KARLA | ||||||||
| OtherNamePrefix: | |||||||||
| OtherNameSuffix: | |||||||||
| OtherCredential: | MA ED, LICSW | ||||||||
| OtherLastNameType: | 1 | ||||||||
| Mailing Information | |||||||||
| Address1: | 2829 VERNDALE AVE | ||||||||
| Address2: | SUITE 3 | ||||||||
| City: | ANOKA | ||||||||
| State: | MN | ||||||||
| PostalCode: | 553031620 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7632312590 | ||||||||
| FaxNumber: | 6127285301 | ||||||||
| Practice Location | |||||||||
| Address1: | 2829 VERNDALE AVE | ||||||||
| Address2: | SUITE 3 | ||||||||
| City: | ANOKA | ||||||||
| State: | MN | ||||||||
| PostalCode: | 553031620 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7632312590 | ||||||||
| FaxNumber: | 6127285301 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 12/04/2009 | ||||||||
| LastUpdateDate: | 12/04/2009 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | |||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 1041C0700X | 11766 | MN | Y | Behavioral Health & Social Service Providers | Social Worker | Clinical | 1041S0200X | 358288 | MN | N | Behavioral Health & Social Service Providers | Social Worker | School |
No ID Information.