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General NPI Number Information
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NPI Number | 1083738603
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Entity Type | Individual
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Provider Name | GERALDINE MARY ROCKETT PH.D.
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Gender | Female
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Dates
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Enumeration Date | 03/19/2007
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Last Update Date | 05/23/2019
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Provider Practice Location Address
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Address Line | 1895 LAUREL AVE ST. MARY'S EPISCOPAL CHURCH OFFICE BUILDING
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City | SAINT PAUL
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State | MN
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Zip | 55104-5938
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Country | US
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Telephone | 651-294-2337
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Fax |
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Provider Business Mailing Address
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Address Line | 1895 ASHLAND AVE
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City | SAINT PAUL
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State | MN
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Zip | 55104-5949
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Country | US
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Telephone | 651-644-4386
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TC1900X
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Taxonomy Name | Counseling Psychologist
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License Number | LPO439
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License Number State | MN
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