Individual
KASSANDRA LEE REKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LMHP, PLP
Contact information
Practice address
3800 PARK NICOLLET BLVD, ST LOUIS PARK, MN 55416-2527
(952) 993-3286
Mailing address
8170 33RD AVE S # MS 21110Q, BLOOMINGTON, MN 55425-4516
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
10566
NE
103T00000X
Psychologist
Primary
LP6192
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
10026139700
—
NE
05
—
47037660624
—
NE
05
—
47037660631
—
NE
Enumeration date
07/07/2015
Last updated
03/12/2021
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