Individual
REBECCA LAIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1100 GLENWOOD AVE, MINNEAPOLIS, MN 55405-1430
(612) 871-1454
(612) 871-1505
Mailing address
109 N FAIRLAND ST, PRYOR, OK 74361-4203
(918) 825-1405
(918) 825-1406
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
—
—
Other
Enumeration date
07/29/2019
Last updated
06/16/2022
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