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Individual

LISA RICHARDSON

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
MSS, LICSW

Contact information

Practice address
1821 UNIVERSITY AVE W, STE. N-464, SAINT PAUL, MN 55104-2887
(651) 659-2900
Mailing address
988 CHEROKEE AVE, WEST SAINT PAUL, MN 55118-1111
(651) 552-4694

Taxonomy

Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
004171
CT
1041C0700X
Clinical Social Worker
Primary
17412
MN

Other

Enumeration date
12/04/2006
Last updated
07/09/2007
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