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NPI Code Detail

MEDICARE: MS. PATRICE LAUER-ROBERTS LICSW

MEDICARE: MS. PATRICE LAUER-ROBERTS LICSW
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
11041C0700XClinical Social Worker14910MN

General Provider Information

NPI Number : 1750366167
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. PATRICE LAUER-ROBERTS LICSW
Provider Business Mailing Address
First Line : 3450 OLEARY LN
Second Line :
City : EAGAN
State : MN
Zip : 55123-2340
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 3450 OLEARY LN
Second Line :
City : EAGAN
State : MN
Zip : 55123-2340
Country : US
Telephone Number : 651-454-0114
Fax Number : 651-454-3492
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/08/2005
Last Update Date : 07/08/2007

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Directions to “ MS. PATRICE LAUER-ROBERTS LICSW” Practice Location

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