Provider Demographics
NPI:1861742884
Name:RADEMACHER, LAURA ELIZABETH (MA)
Entity type:Individual
Prefix:MS
First Name:LAURA
Middle Name:ELIZABETH
Last Name:RADEMACHER
Suffix:
Gender:F
Credentials:MA
Other - Prefix:MS
Other - First Name:LAURA
Other - Middle Name:ELIZABETH
Other - Last Name:REESE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:5871 CEDAR LAKE RD S STE 220
Mailing Address - Street 2:
Mailing Address - City:ST LOUIS PARK
Mailing Address - State:MN
Mailing Address - Zip Code:55416-3804
Mailing Address - Country:US
Mailing Address - Phone:612-460-0828
Mailing Address - Fax:
Practice Address - Street 1:5871 CEDAR LAKE RD S STE 220
Practice Address - Street 2:
Practice Address - City:ST LOUIS PARK
Practice Address - State:MN
Practice Address - Zip Code:55416-3804
Practice Address - Country:US
Practice Address - Phone:612-460-0828
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-09-17
Last Update Date:2012-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist