Individual
MRS. MORGAN RAE LASALLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LMFT, BCBA
Contact information
Practice address
160 3RD AVE NW, MILACA, MN 56353
(320) 983-2335
Mailing address
30605 100TH AVE, ONAMIA, MN 56359-2162
(320) 733-0411
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
1-12-12579
CA
106H00000X
Marriage & Family Therapist
Primary
3372
MN
106H00000X
Marriage & Family Therapist
82223
CA
Other
Enumeration date
06/12/2012
Last updated
11/29/2018
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