Healthcare Provider Details

I. General information

NPI: 1437821410
Provider Name (Legal Business Name): HANNAH WILLIAMS ROTHAUSEN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/29/2021
Last Update Date: 05/18/2026
Certification Date: 05/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4601 EXCELSIOR BLVD STE 403
ST LOUIS PARK MN
55416-4977
US

IV. Provider business mailing address

4601 EXCELSIOR BLVD STE 403
MINNEAPOLIS MN
55416-4977
US

V. Phone/Fax

Practice location:
  • Phone: 612-389-8666
  • Fax:
Mailing address:
  • Phone: 612-389-8666
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number3822
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: