Individual
ARISA KOYAMA LYSENG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
4660 SLATER RD STE 120, EAGAN, MN 55122-4048
(612) 441-3255
Mailing address
4660 SLATER RD STE 120, EAGAN, MN 55122-4048
(612) 441-3255
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
CC03768
MN
Other
Enumeration date
09/14/2019
Last updated
12/15/2023
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