Individual
LISA VAN TASSELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MA, LPC
Contact information
Practice address
9075 QUADAY AVE NE, SUITE 102, ELK RIVER, MN 55330-6672
(763) 746-9492
Mailing address
1900 SILVER LAKE RD NW, SUITE 110, NEW BRIGHTON, MN 55112-1786
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
LPC00537
MN
Other
Enumeration date
04/08/2009
Last updated
04/08/2009
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