Organization
REVERIE MENTAL HEALTH PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MACKENZIE KAMPA APRN (OWNER)
(612) 405-0414
Entity
Organization
Contact information
Practice address
32 10TH AVE S STE 206, HOPKINS, MN 55343-9481
(612) 405-0414
(571) 376-6561
Mailing address
32 10TH AVE S STE 206, HOPKINS, MN 55343-9481
(612) 405-0414
(571) 376-6561
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
—
—
Other
Enumeration date
09/13/2022
Last updated
05/17/2024
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