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Individual

MAVIS RICE

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MA LP

Contact information

Practice address
6542 REGENCY LN, SUITE 206, EDEN PRAIRIE, MN 55344-7847
(952) 736-7136
(952) 903-9257
Mailing address
6542 REGENCY LANE, SUITE 206, EDEN PRAIRIE, MN 55344
(952) 736-7136
(952) 903-9257

Taxonomy

Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
LP4004
MN
103TC0700X
Clinical Psychologist
Primary
4004
MN
103TP2701X
Group Psychotherapy Psychologist
Primary
LP4004
MN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
167373
U CARE
MN
01
30433-01
PREFERREDONE (BPH)
MN
05
386981400
MN
01
39Q41BU
BCBS GROUP
MN
01
62-50536
MEDICA/UBH
MN
01
83G85K1
BCBS INDIVIDUAL
MN
01
HP50743
HEALTHPARTNERS
FM
Enumeration date
10/24/2006
Last updated
02/08/2026
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