=====================================================
General NPI Number Information
=====================================================
NPI Number | 1548057227
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | REDEFINING FUERZA LTD
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 04/24/2025
-----------------------------------------------------
Last Update Date | 04/24/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 229 JACKSON ST STE 120
-----------------------------------------------------
City | ANOKA
-----------------------------------------------------
State | MN
-----------------------------------------------------
Zip | 55303-2254
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 612-999-8526
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 1728 121ST AVE NW APT 4
-----------------------------------------------------
City | MINNEAPOLIS
-----------------------------------------------------
State | MN
-----------------------------------------------------
Zip | 55448-7521
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 414-412-9683
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | PRESIDENT
-----------------------------------------------------
Name | MORGAN BREE MESSER
-----------------------------------------------------
Credential | MS, LMFT
-----------------------------------------------------
Telephone | 414-412-9683
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 106H00000X
-----------------------------------------------------
Taxonomy Name | Marriage & Family Therapist
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------