Healthcare Provider Details

I. General information

NPI: 1497818827
Provider Name (Legal Business Name): BETH ANN APONTE LICSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: BETH ANN RECHKEMMER LICSW

II. Dates (important events)

Enumeration Date: 12/18/2006
Last Update Date: 05/02/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1106 W DEPUE AVE
OLIVIA MN
56277-1230
US

IV. Provider business mailing address

1106 W DEPUE AVE
OLIVIA MN
56277
US

V. Phone/Fax

Practice location:
  • Phone: 320-523-1300
  • Fax: 320-523-1300
Mailing address:
  • Phone: 320-523-1300
  • Fax: 320-523-1300

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number16758
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: