Individual
MS. LISA JACQUELINE WEBER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LGSW
Contact information
Practice address
5700 BOTTINEAU BLVD STE 210, CRYSTAL, MN 55429-3184
(763) 330-2774
Mailing address
4417 2ND AVE S, MINNEAPOLIS, MN 55419-5103
(612) 806-1653
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
28873
MN
Other
Enumeration date
08/17/2022
Last updated
08/17/2022
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