Individual
JANICE M LAVINE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PH.D.
Contact information
Practice address
5001 AMERICAN BLVD W, 990, BLOOMINGTON, MN 55437-1108
(952) 897-0506
Mailing address
5001 AMERICAN BLVD W, 990, BLOOMINGTON, MN 55437-1108
(952) 897-0506
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
6676
MN
106H00000X
Marriage & Family Therapist
266
MN
Other
Enumeration date
04/10/2007
Last updated
09/11/2025
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