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General NPI Number Information
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NPI Number | 1326531724
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Entity Type | Organization
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Legal Business Name | DR. REBECCA HERN, PLLC
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Dates
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Enumeration Date | 06/11/2018
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Last Update Date | 07/12/2023
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Provider Practice Location Address
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Address Line | 209 CHURCHILL ST W STE 102
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City | STILLWATER
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State | MN
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Zip | 55082-6216
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Country | US
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Telephone | 651-564-9912
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 138
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City | HUGO
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State | MN
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Zip | 55038-0138
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Country | US
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Telephone | 651-564-9912
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Fax |
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Authorized Official
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Title or Position | CLINICAL PSYCHOLOGIST
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Name | REBECCA HERN
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Credential |
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Telephone | 651-564-9912
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number |
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License Number State |
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