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1932722592
LILY ROSE LARSON
BLOOMINGTON, MN
NPI
1932722592
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
101YA0400X Counselor, Addiction (Substance Use Disorder)
(Licence: MN 305897)
Enumeration Date
2020-05-18
Last Update Date
2020-12-14
Business Address
LILY ROSE LARSON
1101 E 78TH ST
BLOOMINGTON, MN 55420-1400
Phone number: 952-234-6860
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Mailing Address
LILY ROSE LARSON
5790 145TH CT NW
RAMSEY, MN 55303-5684
Phone number:
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