Individual
MS. RIKI KRAVITZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.A., L.P.
Contact information
Practice address
1516 W LAKE ST, MINNEAPOLIS, MN 55408-2554
(612) 822-1357
(612) 822-1360
Mailing address
2712 FREMONT AVE S, MINNEAPOLIS, MN 55408-1122
(612) 822-1357
(612) 822-1360
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
LP1081
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0G162KR
BLUE CROSS BLUE SHIELD
—
01
—
6253210
UBH
—
Enumeration date
03/15/2007
Last updated
03/29/2018
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