Provider Demographics
NPI:1730772914
Name:BACHMEIER, REBECCA L (LGSW)
Entity type:Individual
Prefix:
First Name:REBECCA
Middle Name:L
Last Name:BACHMEIER
Suffix:
Gender:F
Credentials:LGSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11445 SUMTER AVE N
Mailing Address - Street 2:
Mailing Address - City:CHAMPLIN
Mailing Address - State:MN
Mailing Address - Zip Code:55316-2791
Mailing Address - Country:US
Mailing Address - Phone:763-350-6572
Mailing Address - Fax:
Practice Address - Street 1:9201 QUADAY AVE NE
Practice Address - Street 2:
Practice Address - City:OTSEGO
Practice Address - State:MN
Practice Address - Zip Code:55330-6602
Practice Address - Country:US
Practice Address - Phone:763-703-6962
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-02-18
Last Update Date:2021-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker