MEDICARE: DR. KATHRYN O'REGAN RIMSTAD PH.D.

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	103TC1900X	Counseling Psychologist

General Provider Information

NPI Number	:	1386922342
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. KATHRYN O'REGAN RIMSTAD PH.D.

Provider Business Mailing Address
First Line	:	6808 4TH AVE S
Second Line	:
City	:	RICHFIELD
State	:	MN
Zip	:	55423-2424
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1536 HEWITT AVE
Second Line	:	COUNSELING AND HEALTH SERVICES
City	:	SAINT PAUL
State	:	MN
Zip	:	55104-1205
Country	:	US
Telephone Number	:	651-523-2204
Fax Number	:

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

Provider Enumeration Date	:	07/25/2011
Last Update Date	:	07/25/2011

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