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NPI Code Detail

MEDICARE: MRS. GRACIA ELIZABETH RINDEN LICSW

MEDICARE:  MRS. GRACIA ELIZABETH RINDEN  LICSW
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
11041C0700XClinical Social Worker06168MN

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1157T4RIOTHERMNBCBS
2120111OTHERMNMMSI

General Provider Information

NPI Number : 1639226152
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. GRACIA ELIZABETH RINDEN LICSW
Provider Business Mailing Address
First Line : PO BOX 9005
Second Line :
City : ROCHESTER
State : MN
Zip : 55903-9005
Country : US
Telephone Number : 507-529-0190
Fax Number : 507-292-8986
Provider Business Practice Location Address
First Line : 1925 CENTURY VALLEY RD NE
Second Line :
City : ROCHESTER
State : MN
Zip : 55906
Country : US
Telephone Number : 507-282-5492
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/05/2007
Last Update Date : 07/08/2007

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