Individual
LISA MARIE RAINES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MA
Contact information
Practice address
8170 OLD CARRIAGE CT, SUITE 200, SHAKOPEE, MN 55379-3163
(612) 483-4464
Mailing address
509 CHATFIELD LN, BELLE PLAINE, MN 56011-1134
(612) 483-4464
Taxonomy
Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
Primary
2454
MN
Other
Enumeration date
04/24/2012
Last updated
04/24/2012
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