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Individual

MRS. LISA MARIE RUTFORD

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
MA, LPCC

Contact information

Practice address
6550 YORK AVE S STE 503, EDINA, MN 55435-2336
(952) 426-3034
Mailing address
3531 10TH AVE S UNIT 2, MINNEAPOLIS, MN 55407-2115
(847) 293-9649

Taxonomy

Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
CC01825
MN

Other

Enumeration date
06/18/2019
Last updated
06/18/2019
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