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NPI Code Detail

MEDICARE: PAMELA REIGEL MA, LMFT

MEDICARE: PAMELA REIGEL MA, LMFT
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
1106H00000XMarriage & Family Therapist2939MN

General Provider Information

NPI Number : 1972900041
Entity Type Code : Individual
Provider Name (Legal Business Name) : PAMELA REIGEL MA, LMFT
Provider Business Mailing Address
First Line : 3333 UNIVERSITY AVE SE
Second Line :
City : MINNEAPOLIS
State : MN
Zip : 55414-3325
Country : US
Telephone Number : 952-939-0396
Fax Number : 952-548-8760
Provider Business Practice Location Address
First Line : 9120 SPRINGBROOK DR NW
Second Line :
City : COON RAPIDS
State : MN
Zip : 55433-5845
Country : US
Telephone Number : 952-939-0396
Fax Number : 952-548-8760
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/04/2014
Last Update Date : 04/09/2018

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