Individual
LUL NUR
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPCC
Contact information
Practice address
425 20TH AVE S, MINNEAPOLIS, MN 55454-4400
(612) 332-4973
(612) 238-3534
Mailing address
425 20TH AVE S, MINNEAPOLIS, MN 55454-4400
(612) 332-4973
(612) 238-3534
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
CC01613
MN
Other
Enumeration date
03/17/2011
Last updated
12/01/2017
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