Individual
LISA BONAHOOM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LMFT
Contact information
Practice address
3525 MONTEREY DR, ST LOUIS PARK, MN 55416-5275
(952) 993-6200
Mailing address
2436 STEVENS AVE, MINNEAPOLIS, MN 55404-3529
(952) 240-9404
Taxonomy
Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
Primary
3111
MN
Other
Enumeration date
05/18/2015
Last updated
05/18/2015
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