Healthcare Provider Details

I. General information

NPI: 1376447359
Provider Name (Legal Business Name): EMILY RIEBEL ED.S, NCSP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/05/2026
Last Update Date: 10/05/2026
Certification Date: 10/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1240 COUNTY ROAD B2 W
ROSEVILLE MN
55113-4338
US

IV. Provider business mailing address

1240 COUNTY ROAD B2 W
ROSEVILLE MN
55113-4338
US

V. Phone/Fax

Practice location:
  • Phone: 651-604-1468
  • Fax: 651-635-1660
Mailing address:
  • Phone: 651-604-1468
  • Fax: 651-635-1660

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TS0200X
TaxonomySchool Psychologist
License Number36201
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: