Individual
ERIC LY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
721 COMMERCE DR, WOODBURY, MN 55125-9118
(651) 424-4000
Mailing address
5110 KIRKWOOD AVE N, LAKE ELMO, MN 55042-9559
(612) 644-6835
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
CC04553
MN
Other
Enumeration date
04/25/2019
Last updated
09/19/2024
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