Provider Demographics
NPI:1104016815
Name:SHOEMAKER, MARGARET A (LICSW IN MINNESOTA)
Entity Type:Individual
Prefix:MS
First Name:MARGARET
Middle Name:A
Last Name:SHOEMAKER
Suffix:
Gender:F
Credentials:LICSW IN MINNESOTA
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Mailing Address - Street 1:1100 GLENWOOD AVE
Mailing Address - Street 2:WASHBURN CENTER FOR CHILDREN
Mailing Address - City:MINNEAPOLIS
Mailing Address - State:MN
Mailing Address - Zip Code:55405-1430
Mailing Address - Country:US
Mailing Address - Phone:612-871-1454
Mailing Address - Fax:612-871-1505
Practice Address - Street 1:1100 GLENWOOD AVE
Practice Address - Street 2:WASHBURN CENTER FOR CHILDREN
Practice Address - City:MINNEAPOLIS
Practice Address - State:MN
Practice Address - Zip Code:55405-1430
Practice Address - Country:US
Practice Address - Phone:612-871-1454
Practice Address - Fax:612-871-1505
Is Sole Proprietor?:Yes
Enumeration Date:2007-07-29
Last Update Date:2014-12-10
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
WI6715-1231041C0700X
MN55391041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI43596800Medicaid