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NPI Code Detail

MEDICARE: VANESSA EAMES MA, LP

MEDICARE: VANESSA EAMES MA, LP
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
1103T00000XPsychologistLP5166MN
2101YP2500XProfessional Counselor

General Provider Information

NPI Number : 1699006973
Entity Type Code : Individual
Provider Name (Legal Business Name) : VANESSA EAMES MA, LP
Provider Business Mailing Address
First Line : 1919 UNIVERSITY AVE W STE 200
Second Line :
City : SAINT PAUL
State : MN
Zip : 55104-3435
Country : US
Telephone Number : 651-266-7999
Fax Number : 651-266-7850
Provider Business Practice Location Address
First Line : 2925 CHICAGO AVE
Second Line :
City : MINNEAPOLIS
State : MN
Zip : 55407-1321
Country : US
Telephone Number : 866-603-0016
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/26/2010
Last Update Date : 08/31/2022

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