Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103K00000X | Behavior Analyst | 1-11-8188 | MN |
NPI | 1003231663 |
---|---|
Provider Name | Lisa Marie Barsness |
First Address | Minneapolis, MN 55416-7700 |
Second Address | Minneapolis, MN 55416-7700 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 19/02/2014 |
Last Update Date | 06/11/2019 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1-11-8188 | BCBA (01) | MN |