Individual
MRS. MICHELLE MARIE LIVELY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LSW
Contact information
Practice address
227 COLFAX AVE N, 130, MINNEAPOLIS, MN 55405-1402
(651) 222-0757
Mailing address
227 COLFAX AVE N, 130, MINNEAPOLIS, MN 55405-1402
(651) 222-0757
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
09/03/2013
Last updated
09/03/2013
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