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General NPI Number Information
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NPI Number | 1104621333
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Entity Type | Organization
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Legal Business Name | ROSEWATER MENTAL HEALTH PLLC
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Dates
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Enumeration Date | 02/13/2025
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Last Update Date | 02/13/2025
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Provider Practice Location Address
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Address Line | 7319 JOLIET CIR S
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City | COTTAGE GROVE
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State | MN
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Zip | 55016-3633
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Country | US
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Telephone | 612-770-0986
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Fax |
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Provider Business Mailing Address
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Address Line | 7319 JOLIET CIR S
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City | COTTAGE GROVE
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State | MN
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Zip | 55016-3633
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Country | US
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Telephone | 612-770-0986
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | REBECCA MURPHY
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Credential | PSYD, LP
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Telephone | 612-770-0986
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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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