Healthcare Provider Details

I. General information

NPI: 1669790432
Provider Name (Legal Business Name): LEA ROSE SEMLER MS, LMFT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/04/2010
Last Update Date: 06/12/2026
Certification Date: 06/12/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12760 ABERDEEN ST NE STE 102
BLAINE MN
55449-5845
US

IV. Provider business mailing address

5123 COUNTY ROAD 6 NW
DALBO MN
55017-8305
US

V. Phone/Fax

Practice location:
  • Phone: 612-232-1202
  • Fax:
Mailing address:
  • Phone: 612-232-1202
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number1723
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: