MEDICARE: VANESSA UWAMUKIZA RYPA

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	101YM0800X	Mental Health Counselor

General Provider Information

NPI Number	:	1841982717
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	VANESSA UWAMUKIZA RYPA

Provider Business Mailing Address
First Line	:	1044 BUSH AVE
Second Line	:
City	:	SAINT PAUL
State	:	MN
Zip	:	55106-3930
Country	:	US
Telephone Number	:	651-352-7278
Fax Number	:

Provider Business Practice Location Address
First Line	:	1044 BUSH AVE
Second Line	:
City	:	SAINT PAUL
State	:	MN
Zip	:	55106-3930
Country	:	US
Telephone Number	:	651-352-7278
Fax Number	:

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

Provider Enumeration Date	:	05/22/2023
Last Update Date	:	05/22/2023

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