HOLLY JUSTINE LASTINE

FRIDLEY, MN
NPI1720600547
Former NameHOLLY JUSTINE STURGES
Entity TypeIndividual
GenderFemale
Sole Proprietor ?Yes
Primary Taxonomy1041C0700X Social Worker, Clinical
(Licence: OR  LCSW7975)
Additional Taxonomies1041C0700X Social Worker, Clinical
(Licence: OR  7975)
Enumeration Date2020-05-14
Last Update Date2023-06-27
Business Address
HOLLY JUSTINE LASTINE LCSW, LICSW
7895 EAST RIVER ROAD APT 201
FRIDLEY, MN 55432
Phone number: 707-496-0167
Mailing Address
HOLLY JUSTINE LASTINE LCSW, LICSW
7895 EAST RIVER ROAD APT 201
FRIDLEY, MN 55432
Phone number: 707-496-0167