Provider Demographics
NPI:1821872110
Name:ARNESON, PATRICIA JO (LICSW)
Entity Type:Individual
Prefix:
First Name:PATRICIA
Middle Name:JO
Last Name:ARNESON
Suffix:
Gender:F
Credentials:LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:915 TRIUMPH TRL NE
Mailing Address - Street 2:
Mailing Address - City:ISANTI
Mailing Address - State:MN
Mailing Address - Zip Code:55040-4460
Mailing Address - Country:US
Mailing Address - Phone:612-986-0133
Mailing Address - Fax:
Practice Address - Street 1:915 TRIUMPH TRL NE
Practice Address - Street 2:
Practice Address - City:ISANTI
Practice Address - State:MN
Practice Address - Zip Code:55040-4460
Practice Address - Country:US
Practice Address - Phone:612-986-0133
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-08-21
Last Update Date:2023-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN149011041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical