| NPI | 1598150930 |
|---|---|
| Doing Business As | MARYANNE LASSEGARD |
| Entity Type | Organization |
| Authorized Contact | MARY ANNE LASSEGARD Owner 612-306-4721 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208VP0014X Pain Medicine, Interventional Pain Medicine (Licence: MN LP2187) |
| Additional Taxonomies | 103TB0200X Psychologist, Cognitive & Behavioral (Licence: MN LP2187) |
| 103TC0700X Psychologist, Clinical (Licence: MN LP2187) | |
| 103TH0100X Psychologist, Health Service (Licence: MN LP2187) | |
| 103TP2701X Psychologist, Group Psychotherapy (Licence: MN LP2187) | |
| Enumeration Date | 2015-04-02 |
| Last Update Date | 2015-04-02 |