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General NPI Number Information
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NPI Number | 1548006208
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Entity Type | Individual
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Provider Name | BRENDA JOYCE RAHN LP
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Gender | Female
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Dates
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Enumeration Date | 07/02/2024
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Last Update Date | 07/16/2024
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Provider Practice Location Address
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Address Line | 930 GALLOWAY ST STE 101
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City | EAU CLAIRE
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State | WI
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Zip | 54703-3913
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Country | US
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Telephone | 715-595-3714
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 251
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City | HOLCOMBE
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State | WI
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Zip | 54745-0251
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Country | US
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Telephone | 715-595-3714
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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 | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | 3251-57
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License Number State | WI
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