Individual
DR. MARY K VANREKEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PHD
Contact information
Practice address
7800 METRO PKWY STE 300, BLOOMINGTON, MN 55425-1509
(952) 854-4116
(952) 854-4199
Mailing address
7800 METRO PKWY STE 300, BLOOMINGTON, MN 55425-1509
(952) 854-4116
(952) 854-4199
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
LP 3060
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
142661
UCARE-MN
FM
01
—
337731
VALUE OPTIONS
MN
01
—
61-52099
UBH
FM
01
—
64G50VA
BCBSMN
MN
01
—
7201179
AETNA
MN
Enumeration date
07/12/2006
Last updated
07/09/2007
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