Healthcare Provider Details

I. General information

NPI: 1245147198
Provider Name (Legal Business Name): LOLA RUFF
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/26/2026
Last Update Date: 08/26/2026
Certification Date: 08/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3441 CEDAR AVE S
MINNEAPOLIS MN
55407-2336
US

IV. Provider business mailing address

3262 LIBRARY LN
ST LOUIS PARK MN
55426-4102
US

V. Phone/Fax

Practice location:
  • Phone: 612-440-1450
  • Fax: 612-524-5563
Mailing address:
  • Phone: 952-228-9930
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: