Grinnell, Diane Rae

Grinnell, Diane Rae is an sole proprietor health care provider with primary practice located at 3450 Oleary Ln , Eagan MN 55123-2340. She recently has only one registered license in Behavioral Health & Social Service Providers / Clinical, which is considered as her primary health care specialty. Grinnell, Diane Rae can be contacted via phone (651) 454-0114.

Contact Information

Primary practice address
3450 Oleary Ln Eagan MN 55123-2340
Fax: (651) 454-3492
Website:

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Clinical 1041C0700X 8942 Minnesota

Profile Details

NPI number 1649366808
LBN Legal business name Grinnell, Diane Rae
Credentials LICSW
Entity Individual
Sole proprietor 1 Yes
Enumeration date Oct 5th, 2006
Last updated Mar 21st, 2018 - about 6 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1649366808 NPPES
Minnesota Other 60F01GR BCBS
Minnesota Other 62-60394 BCBS
Minnesota Other 018757700 BCBS
Minnesota Other 123136 BCBS
Minnesota Other HP17977 BCBS
Minnesota Other 41-1546550 BCBS

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