Individual
LAURA LOPEZ NYSTROM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MSW, LICSW
Contact information
Practice address
381 ROBIE ST E, SAINT PAUL, MN 55107-2415
(651) 222-0757
(651) 290-2703
Mailing address
381 ROBIE ST E, SAINT PAUL, MN 55107-2415
(651) 222-0757
(651) 290-2703
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
10664
MN
Other
Enumeration date
09/09/2013
Last updated
09/09/2013
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