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Individual

JESSE RAPPAPORT

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
L.C.S.W.

Contact information

Practice address
2705 ALABAMA AVE S, ST LOUIS PARK, MN 55416-1801
(503) 407-9349
Mailing address
2705 ALABAMA AVE S, ST LOUIS PARK, MN 55416-1801
(503) 407-9349

Taxonomy

Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
1077
OR
1041C0700X
Clinical Social Worker
30378
MN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1077
STATE LICENSE NUMBER
OR
01
30378
STATE SOCIAL WORK LICENSE NUMBER
MN
Enumeration date
08/24/2006
Last updated
10/15/2024
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