Whalio Doctors

NPI 1154814564

Laurie K. Tazelaar-Williams

Practitioner Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility White Bear Lake, MN

Practice location

Address
5253 W Bald Eagle Blvd, White Bear Lake, MN 55110-6532
Phone
(612) 380-3333
Mailing address
PO Box 10818, White Bear Lake, MN 55110-0818

Registered specialties

Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility Primary
Residential Treatment Facilities Taxonomy 320900000X

Registry record

NPI
1154814564
Entity type
Individual
Sex (as registered)
Female
NPI issued
11 Jun 2018
Record last updated
11 Jun 2018

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.