Provider Demographics
NPI:1649430257
Name:DINNEN, LAUREL (LGSW)
Entity type:Individual
Prefix:
First Name:LAUREL
Middle Name:
Last Name:DINNEN
Suffix:
Gender:F
Credentials:LGSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 9310
Mailing Address - Street 2:CP320
Mailing Address - City:MINNEAPOLIS
Mailing Address - State:MN
Mailing Address - Zip Code:55440-9310
Mailing Address - Country:US
Mailing Address - Phone:952-992-3386
Mailing Address - Fax:
Practice Address - Street 1:401 CARLSON PKWY
Practice Address - Street 2:CP320
Practice Address - City:MINNETONKA
Practice Address - State:MN
Practice Address - Zip Code:55305-5359
Practice Address - Country:US
Practice Address - Phone:952-992-3386
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-06-17
Last Update Date:2008-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN17451171M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator