Healthcare Provider Details

I. General information

NPI: 1982508644
Provider Name (Legal Business Name): ROSARIO LOURDES MUIR (FORMERLY BOSTWICK MA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: ROSARIO LOURDES BOSTWICK

II. Dates (important events)

Enumeration Date: 10/06/2026
Last Update Date: 10/06/2026
Certification Date: 10/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

34 13TH AVE NE STE B001
MINNEAPOLIS MN
55413-1005
US

IV. Provider business mailing address

414 7TH AVE SE APT B306
MINNEAPOLIS MN
55414-1842
US

V. Phone/Fax

Practice location:
  • Phone: 612-208-7710
  • Fax:
Mailing address:
  • Phone: 612-442-2227
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: