Individual
LAINEY C MANNIX
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MSW, LICSW
Contact information
Practice address
3800 PARK NICOLLET BLVD STE 650, ST LOUIS PARK, MN 55416-2527
(952) 993-9803
(952) 993-2505
Mailing address
8170 33RD AVE S # MS 21110Q, BLOOMINGTON, MN 55425-4516
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
28615
MN
Other
Enumeration date
11/30/2022
Last updated
12/02/2022
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