Provider Demographics
NPI:1437370731
Name:LAWSON-PHILLIPS, LAURA
Entity Type:Individual
Prefix:
First Name:LAURA
Middle Name:
Last Name:LAWSON-PHILLIPS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2800 UNIVERSITY AVE SE STE 204
Mailing Address - Street 2:
Mailing Address - City:MINNEAPOLIS
Mailing Address - State:MN
Mailing Address - Zip Code:55414-4205
Mailing Address - Country:US
Mailing Address - Phone:612-331-4429
Mailing Address - Fax:612-331-3520
Practice Address - Street 1:2800 UNIVERSITY AVE SE STE 204
Practice Address - Street 2:
Practice Address - City:MINNEAPOLIS
Practice Address - State:MN
Practice Address - Zip Code:55414-4205
Practice Address - Country:US
Practice Address - Phone:612-331-4429
Practice Address - Fax:612-331-3520
Is Sole Proprietor?:No
Enumeration Date:2007-05-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN12816104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker