Individual
LANSA DAWANO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
3707 104TH TRL N, MINNEAPOLIS, MN 55443-1012
(612) 221-3554
Mailing address
3707 104TH TRL N, MINNEAPOLIS, MN 55443-1012
(612) 221-3554
Taxonomy
Speciality
Code
Description
License number
State
372600000X
Adult Companion
Primary
1098517
MN
Other
Enumeration date
11/06/2019
Last updated
01/13/2020
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