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General NPI Number Information
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NPI Number | 1861801557
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Entity Type | Organization
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Legal Business Name | VANESSA REMPEL PHD, LICENSED PSYCHOLOGIST, LLC
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Dates
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Enumeration Date | 08/06/2014
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Last Update Date | 08/08/2014
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Provider Practice Location Address
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Address Line | 3011 36TH AVE S SUTIE 19
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City | MINNEAPOLIS
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State | MN
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Zip | 55406-2124
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Country | US
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Telephone | 763-516-4627
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Fax |
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Provider Business Mailing Address
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Address Line | 3011 36TH AVE S SUTIE 10
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City | MINNEAPOLIS
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State | MN
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Zip | 55406-2124
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Country | US
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Telephone | 763-516-4627
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | VANESSA REMPEL
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Credential | PHD, LP
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Telephone | 763-516-4627
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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 | 5129
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License Number State | MN
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