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General NPI Number Information
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NPI Number | 1497461461
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Entity Type | Individual
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Provider Name | MICHELLE REICHERT LICSW
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Gender | Female
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Dates
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Enumeration Date | 01/24/2023
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Last Update Date | 01/24/2023
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Provider Practice Location Address
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Address Line | 7545 VETERANS DR
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City | RAMSEY
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State | MN
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Zip | 55303-7500
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Country | US
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Telephone | 612-467-1100
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Fax |
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Provider Business Mailing Address
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Address Line | 19438 MEADOW RUE CT
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City | CORCORAN
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State | MN
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Zip | 55340-1501
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Country | US
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Telephone | 360-951-9210
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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 | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 29626
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License Number State | MN
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