Individual
MR. MANZAR IMTIAZ LARI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.A., LP, LICSW
Contact information
Practice address
2908 HUMBOLDT AVE S, MINNEAPOLIS, MN 55408-1953
(612) 327-6786
Mailing address
750 MAINSTREET, #314, HOPKINS, MN 55343-7700
(612) 327-6786
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
1335
MN
1041C0700X
Clinical Social Worker
06421
MN
Other
Enumeration date
11/21/2009
Last updated
11/21/2009
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