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General NPI Number Information
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NPI Number | 1902695117
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Entity Type | Individual
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Provider Name | RACHAEL KAYE KOTTKE MSW, LGSW
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Gender | Female
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Dates
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Enumeration Date | 05/05/2025
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Last Update Date | 05/05/2025
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Provider Practice Location Address
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Address Line | 800 E 28TH ST
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City | MINNEAPOLIS
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State | MN
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Zip | 55407-3723
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Country | US
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Telephone | 612-863-4397
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Fax |
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Provider Business Mailing Address
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Address Line | 1776 MARYLAND AVE E APT 305
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City | SAINT PAUL
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State | MN
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Zip | 55106-2982
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Country | US
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Telephone | 651-307-6818
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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 | 104100000X
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Taxonomy Name | Social Worker
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License Number | 32316
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License Number State | MN
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