Individual
DAN BANNISTER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LICSW
Contact information
Practice address
1523 HIGHWAY 13 E, BURNSVILLE, MN 55337-2917
(952) 894-4828
(952) 894-3737
Mailing address
1523 HIGHWAY 13 E, BURNSVILLE, MN 55337-2917
(952) 894-4828
(952) 894-3737
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
LICSW4951
MN
Other
Enumeration date
04/21/2008
Last updated
04/21/2008
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