Provider Demographics
NPI:1861801557
Name:VANESSA REMPEL PHD, LICENSED PSYCHOLOGIST, LLC
Entity type:Organization
Organization Name:VANESSA REMPEL PHD, LICENSED PSYCHOLOGIST, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:VANESSA
Authorized Official - Middle Name:
Authorized Official - Last Name:REMPEL
Authorized Official - Suffix:
Authorized Official - Credentials:PHD, LP
Authorized Official - Phone:763-516-4627
Mailing Address - Street 1:3011 36TH AVE S
Mailing Address - Street 2:SUTIE 10
Mailing Address - City:MINNEAPOLIS
Mailing Address - State:MN
Mailing Address - Zip Code:55406-2124
Mailing Address - Country:US
Mailing Address - Phone:763-516-4627
Mailing Address - Fax:
Practice Address - Street 1:3011 36TH AVE S
Practice Address - Street 2:SUTIE 19
Practice Address - City:MINNEAPOLIS
Practice Address - State:MN
Practice Address - Zip Code:55406-2124
Practice Address - Country:US
Practice Address - Phone:763-516-4627
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-08-06
Last Update Date:2014-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN5129103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty