Individual
LISA MACKEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1811 GREENVIEW PL SW STE 110, ROCHESTER, MN 55902-4354
(507) 446-0431
Mailing address
2575 HARVEST LANE NW, OWATONNA, MN 55060
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
3069
MN
Other
Enumeration date
03/13/2017
Last updated
03/17/2018
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