Lisa Bonahoom LLC
Marriage & Family Therapist in Long Lake, MN. Organization (NPI-2).
NPI number1033921069
StatusActive
Last updated in NPPESJan 27, 2025
Details
- NPI
- 1033921069
- Entity type
- Organization (NPI-2)
- Legal business name
- Lisa Bonahoom LLC
- Organization subpart
- No
- Enumeration date
- Jan 27, 2025
- Certification date
- Jan 26, 2025
- Last updated
- Jan 27, 2025
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 106H00000X | Marriage & Family Therapist | – | – | Yes |
Practice location
1850 W Wayzata Blvd Ste 150Long Lake, MN 55356-4415
Phone 952-240-9404
Mailing address
1830 Pheasant DrExcelsior, MN 55331-9061
Phone 952-240-9404
Authorized official
Lisa Bonahoom
Ma, Lmft
9522409404
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Other Marriage & Family Therapist providers in Long Lake, MN
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- Anna Katherine Barlage, LMFTNPI 1114304052
- Emilee Marie Rodriguez, LMFTNPI 1942854252
All 5 Marriage & Family Therapist providers in Long Lake · All 49 providers in Long Lake
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