Stellrecht, Diane Louise

Stellrecht, Diane Louise is an sole proprietor health care provider with primary practice located at 4027 County Road 25 , Minneapolis MN 55416-2629. She recently has 2 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Adult Development & Aging, Behavioral Health & Social Service Providers / Clinical. Behavioral Health & Social Service Providers / Clinical is her primary health care specialty. Stellrecht, Diane Louise can be contacted via phone (612) 925-6033.

Contact Information

Primary practice address
4027 County Road 25 Minneapolis MN 55416-2629
Phone: (612) 925-6033
Fax: (612) 925-8496
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Adult Development & Aging 103TA0700X 1130 Minnesota
Behavioral Health & Social Service Providers / Clinical 103TC0700X 1130 Minnesota
Behavioral Health & Social Service Providers / Clinical 103TC0700X LP1130 Minnesota

Profile Details

NPI number 1013108075
LBN Legal business name Stellrecht, Diane Louise
Credentials PHD, LP
Entity Individual
Sole proprietor 1 Yes
Enumeration date Aug 6th, 2007
Last updated Dec 22nd, 2021 - about 4 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 1013108075 NPPES
Minnesota MEDICAID 588350400
Minnesota Other 28682ST

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