MEDICARE: RACHEL LEE RESLER LMFT

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	106H00000X	Marriage & Family Therapist	4051	MN

General Provider Information

NPI Number	:	1366198996
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	RACHEL LEE RESLER LMFT

Provider Business Mailing Address
First Line	:	9040 JACKSON AVE
Second Line	:
City	:	CIRCLE PINES
State	:	MN
Zip	:	55014-3650
Country	:	US
Telephone Number	:	651-338-2445
Fax Number	:

Provider Business Practice Location Address
First Line	:	7525 VILLAGE DR STE 160
Second Line	:
City	:	LINO LAKES
State	:	MN
Zip	:	55014-1305
Country	:	US
Telephone Number	:	651-338-2445
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/22/2022
Last Update Date	:	02/22/2022

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