LANA I. BOUTACOFF

SAINT PAUL, MN
NPI1437213469
Entity TypeIndividual
GenderFemale
Sole Proprietor ?Yes
Primary Taxonomy103T00000X Psychologist
(Licence: MN  LP2623)
Enumeration Date2006-12-21
Last Update Date2007-07-08
Business Address
Dr. LANA I. BOUTACOFF PhD, LP
570 ASBURY ST SUITE 104
SAINT PAUL, MN 55104-1849
Phone number: 651-645-7318
Mailing Address
Dr. LANA I. BOUTACOFF PhD, LP
570 ASBURY ST SUITE 104
SAINT PAUL, MN 55104-1849
Phone number: 651-645-7318