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General NPI Number Information
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NPI Number | 1588734461
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Entity Type | Individual
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Provider Name | RITA C STANOCH LP
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Gender | Female
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Dates
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Enumeration Date | 11/08/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 1030 W COUNTY RD E
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City | SHOREVIEW
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State | MN
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Zip | 55126
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Country | US
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Telephone | 651-482-7900
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Fax |
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Provider Business Mailing Address
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Address Line | 1857 DELLWOOD AVE
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City | ROSEVILLE
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State | MN
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Zip | 55113-6103
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Country | US
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Telephone | 651-482-7900
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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 | 103T00000X
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Taxonomy Name | Psychologist
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License Number | MN1573
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License Number State | MN
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