Individual
LISA M BORNEMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DSW, MSW, LICSW
Contact information
Practice address
2233 HAMLINE AVE N STE 512, ROSEVILLE, MN 55113-5003
(651) 690-6721
Mailing address
2431 GRAND AVE S, MINNEAPOLIS, MN 55405-3432
(612) 578-8864
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
10068
MN
Other
Enumeration date
06/02/2022
Last updated
06/02/2022
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