Individual
LAURA DESOUZA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LICSW
Contact information
Practice address
45 10TH ST W, SAINT PAUL, MN 55102-1062
(651) 232-3000
Mailing address
5004 WOODLAWN BLVD, MINNEAPOLIS, MN 55417-1348
(612) 616-8194
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
19888
MN
Other
Enumeration date
07/17/2012
Last updated
11/17/2014
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