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General NPI Number Information
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NPI Number | 1023982758
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Entity Type | Organization
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Legal Business Name | RENNEKE PSYCH, PLLC
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Dates
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Enumeration Date | 10/04/2025
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Last Update Date | 10/04/2025
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Provider Practice Location Address
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Address Line | 1600 18TH AVE NE UNIT 18028
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City | MINNEAPOLIS
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State | MN
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Zip | 55418-5501
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Country | US
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Telephone | 612-293-7082
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Fax |
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Provider Business Mailing Address
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Address Line | 1600 18TH AVE NE UNIT 18028
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City | MINNEAPOLIS
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State | MN
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Zip | 55418-5501
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Country | US
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Telephone | 612-293-7082
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. ALLISON LAURA RENNEKE
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Credential | PSYD, LP
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Telephone | 612-293-7082
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103T00000X
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Taxonomy Name | Psychologist
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License Number |
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License Number State |
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