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1467204305
LARA DERKSEN
BLOOMINGTON, MN
NPI
1467204305
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Former Name
LARA ELVEHJEM
Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
101Y00000X Counselor
Additional Taxonomies
106S00000X Behavior Technician
Enumeration Date
2024-04-03
Last Update Date
2024-04-03
Business Address
LARA DERKSEN MA
3800 AMERICAN BLVD W STE 740
BLOOMINGTON, MN 55431-4422
Phone number: 612-925-8365
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Mailing Address
LARA DERKSEN MA
3800 AMERICAN BLVD W STE 740
BLOOMINGTON, MN 55431-4422
Phone number:
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