Provider Demographics
NPI:1740569490
Name:EHRMANTRAUT, JOANNE ELOISE (MSW)
Entity Type:Individual
Prefix:
First Name:JOANNE
Middle Name:ELOISE
Last Name:EHRMANTRAUT
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5606 138TH ST N
Mailing Address - Street 2:
Mailing Address - City:HUGO
Mailing Address - State:MN
Mailing Address - Zip Code:55038-8201
Mailing Address - Country:US
Mailing Address - Phone:763-486-3114
Mailing Address - Fax:
Practice Address - Street 1:2680 ARTHUR ST
Practice Address - Street 2:
Practice Address - City:ROSEVILLE
Practice Address - State:MN
Practice Address - Zip Code:55113-1339
Practice Address - Country:US
Practice Address - Phone:651-917-3634
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-08-12
Last Update Date:2017-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN242721041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical