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Individual

MICHELLE RENNIE

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
8401 WAYZATA BLVD, SUITE 150, GOLDEN VALLEY, MN 55426-1343
(763) 544-1006
Mailing address
8401 WAYZATA BLVD, SUITE 150, GOLDEN VALLEY, MN 55426-1343
(763) 544-1006

Taxonomy

Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
Primary
2554
MN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1831239003
COMPANY NPI
MN
Enumeration date
07/18/2016
Last updated
07/18/2016
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