Provider Demographics
NPI:1760243828
Name:FINSTROM, LAURA LEE
Entity Type:Individual
Prefix:
First Name:LAURA
Middle Name:LEE
Last Name:FINSTROM
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 1:3521 E MINERAL POND BLVD
Mailing Address - Street 2:
Mailing Address - City:ANOKA
Mailing Address - State:MN
Mailing Address - Zip Code:55303-1084
Mailing Address - Country:US
Mailing Address - Phone:701-964-1448
Mailing Address - Fax:
Practice Address - Street 1:3499 LEXINGTON AVE N STE 100
Practice Address - Street 2:
Practice Address - City:ARDEN HILLS
Practice Address - State:MN
Practice Address - Zip Code:55126-7058
Practice Address - Country:US
Practice Address - Phone:651-486-4828
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-01-17
Last Update Date:2024-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional