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1437213469
LANA I. BOUTACOFF
SAINT PAUL, MN
NPI
1437213469
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
103T00000X Psychologist
(Licence: MN LP2623)
Enumeration Date
2006-12-21
Last Update Date
2007-07-08
Business Address
Dr. LANA I. BOUTACOFF PhD, LP
570 ASBURY ST SUITE 104
SAINT PAUL, MN 55104-1849
Phone number: 651-645-7318
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Mailing Address
Dr. LANA I. BOUTACOFF PhD, LP
570 ASBURY ST SUITE 104
SAINT PAUL, MN 55104-1849
Phone number: 651-645-7318
Copy
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