Individual
LISANNE BARBARA RACINE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LICSW
Contact information
Practice address
2525 CHICAGO AVE. SOUTH, MINNEAPOLIS, MN 55404-4518
(612) 813-6138
(612) 813-6319
Mailing address
13009 HIALEAH PATH, APPLE VALLEY, MN 55124-9787
(612) 998-5938
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
15170
MN
Other
Enumeration date
09/25/2017
Last updated
09/25/2017
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