Individual
ALISSON LASS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
4000 28TH AVE S, MOORHEAD, MN 56560-7926
(701) 234-3200
Mailing address
PO BOX 5074, SIOUX FALLS, SD 57117-5074
(605) 632-9419
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
641P
ND
103T00000X
Psychologist
Primary
LP7044
MN
Other
Enumeration date
09/13/2024
Last updated
11/04/2024
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