Individual
MS. LISA ANN KNUDSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LICSW
Contact information
Practice address
562 BAVARIA LN, CHASKA, MN 55318-4597
(952) 484-3509
(952) 934-2147
Mailing address
8780 REFLECTIONS RD, CHANHASSEN, MN 55317-4003
(952) 484-3509
(952) 934-2147
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
10527
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
4138228110
—
MN
Enumeration date
11/30/2006
Last updated
01/06/2015
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