Individual
MRS. LISA CASSMAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
12527 CENTRAL AVE NE # 146, BLAINE, MN 55434-4861
(218) 252-0233
Mailing address
12527 CENTRAL AVE NE # 146, BLAINE, MN 55434-4861
(218) 252-0233
Taxonomy
Speciality
Code
Description
License number
State
101YP1600X
Pastoral Counselor
Primary
103K0000X
MN
Other
Enumeration date
10/10/2013
Last updated
10/10/2013
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