Individual
ELISSABETH AMANDA LAUREN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPCC
Contact information
Practice address
600 E 4TH ST, CHASKA, MN 55318-2102
(952) 361-1640
(952) 361-1660
Mailing address
600 E 4TH ST, CHASKA, MN 55318-2102
(952) 361-1640
(952) 361-1660
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
CC00269
MN
Other
Enumeration date
02/08/2011
Last updated
02/09/2011
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