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General NPI Number Information
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NPI Number | 1760651251
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Entity Type | Individual
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Provider Name | JENNIFER LAUREN RIFF PH.D.
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Gender | Female
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Dates
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Enumeration Date | 02/28/2008
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Last Update Date | 02/28/2008
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Provider Practice Location Address
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Address Line | 5704 EXCELSIOR BLVD SUITE B
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City | ST. LOUIS PARK
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State | MN
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Zip | 55416
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Country | US
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Telephone | 952-797-6280
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Fax |
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Provider Business Mailing Address
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Address Line | 7116 LANHAM LN
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City | EDINA
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State | MN
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Zip | 55439-1820
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Country | US
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Telephone | 952-797-6280
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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 | LP4884
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License Number State | MN
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