Individual provider · Type 1 NPI
Alyssa Mae Koktavy Israel, MSW, LGSW
School Social Worker · Cook, MN
NPI number
1063208171
Active
Practice location
10248 E Olson Rd
Cook, MN 55723-8184
Mailing address
116 12th St S
Virginia, MN 55792-2918
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| School Social Worker Primary | 1041S0200X | 34288 (MN) |
School Social Worker: Definition to come...
About NPI 1063208171
Alyssa Mae Koktavy Israel, MSW, LGSW's National Provider Identifier is 1063208171, issued on Apr 16, 2025. The primary taxonomy on file is School Social Worker (1041S0200X), and the practice location is in Cook, MN. The record was last updated on Apr 16, 2025.