Healthcare Provider Details

I. General information

NPI: 1255295333
Provider Name (Legal Business Name): SALINA RENNINGER, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/12/2025
Last Update Date: 12/12/2025
Certification Date: 12/12/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

475 CLEVELAND AVE N STE 200
SAINT PAUL MN
55104-5053
US

IV. Provider business mailing address

475 CLEVELAND AVE N STE 200
SAINT PAUL MN
55104-5053
US

V. Phone/Fax

Practice location:
  • Phone: 651-285-8378
  • Fax: 651-377-4346
Mailing address:
  • Phone: 651-285-8378
  • Fax: 651-377-4346

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC1900X
TaxonomyCounseling Psychologist
License Number
License Number State

VIII. Authorized Official

Name: SALINA RENNINGER
Title or Position: OWNER, PHD, LP
Credential: LP, PHD
Phone: 651-285-8378