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NPI Code Detail

MEDICARE: DR. MARTHA ANNE RICH PH.D.

MEDICARE: DR. MARTHA ANNE RICH PH.D.
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
1103TC0700XClinical PsychologistLP4613MN
2103TC0700XClinical Psychologist2820NC

General Provider Information

NPI Number : 1992742043
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. MARTHA ANNE RICH PH.D.
Provider Business Mailing Address
First Line : 2612 26TH ST NW
Second Line :
City : ROCHESTER
State : MN
Zip : 55901-7648
Country : US
Telephone Number : 507-529-0252
Fax Number :
Provider Business Practice Location Address
First Line : 2746 SUPERIOR DR NW
Second Line : SUITE 370
City : ROCHESTER
State : MN
Zip : 55901-8343
Country : US
Telephone Number : 507-289-7768
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/31/2006
Last Update Date : 07/08/2007

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