Individual
LACEY LYNN SOTO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LICSW
Contact information
Practice address
MAIN AVE, RED LAKE, MN 56671-5650
(218) 204-1955
Mailing address
238 STONE CREEK DR APT 310, DETROIT LAKES, MN 56501-6992
(218) 204-1955
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
25918
MN
Other
Enumeration date
03/01/2021
Last updated
03/01/2021
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