Individual
MS. JANICE LANAY IVERSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPC
Contact information
Practice address
8500 210TH ST W, 140 I, LAKEVILLE, MN 55044-5707
(952) 224-6871
Mailing address
703 PERSHING AVE N, NEW PRAGUE, MN 56071-2163
(952) 224-6871
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
00377
MN
Other
Enumeration date
05/15/2007
Last updated
07/08/2007
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