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General NPI Number Information
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NPI Number | 1487781514
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Entity Type | Individual
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Provider Name | KRISTINE M MEYER-RUBADO MA, LP
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Gender | Female
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Dates
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Enumeration Date | 02/27/2007
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Last Update Date | 06/23/2023
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Provider Practice Location Address
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Address Line | 975 34TH AVE NW SUITE 215
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City | ROCHESTER
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State | MN
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Zip | 55901
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Country | US
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Telephone | 507-288-5818
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Fax | 507-424-1052
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Provider Business Mailing Address
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Address Line | 975 34TH AVE NW SUITE 215
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City | ROCHESTER
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State | MN
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Zip | 55901
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Country | US
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Telephone | 507-288-5818
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Fax | 507-424-1052
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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 | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | LP3442
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License Number State | MN
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Taxonomy #2
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Taxonomy Code | 103TC1900X
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Taxonomy Name | Counseling Psychologist
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License Number | LP3442
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License Number State | MN
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