MEDICARE: DR. CINDY RYCHLING SPIELMAN PSY.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	103T00000X	Psychologist	LP2033	MN
2	103TC1900X	Counseling Psychologist	LP2033	MN
3	103TP2701X	Group Psychotherapy Psychologist	LP2033	MN

General Provider Information

NPI Number	:	1740575596
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. CINDY RYCHLING SPIELMAN PSY.D.

Provider Business Mailing Address
First Line	:	1516 W LAKE STREET
Second Line	:	SUITE 103
City	:	MINNEAPOLIS
State	:	MN
Zip	:	55408
Country	:	US
Telephone Number	:	612-822-1357
Fax Number	:	612-822-1360

Provider Business Practice Location Address
First Line	:	2712 FREMONT AVENUE S
Second Line	:
City	:	MINNEAPOLIS
State	:	MN
Zip	:	55408
Country	:	US
Telephone Number	:	612-872-8218
Fax Number	:	612-874-8885

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

Provider Enumeration Date	:	06/09/2011
Last Update Date	:	06/09/2011

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