Provider Demographics
NPI:1033218599
Name:UNIVERSITY OF MINNESOTA MEDICAL SCHOOL
Entity Type:Organization
Organization Name:UNIVERSITY OF MINNESOTA MEDICAL SCHOOL
Other - Org Name:CENTER FOR RURAL MENTAL HEALTH STUDIES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DIRECTOR OF EXTERNAL SALES
Authorized Official - Prefix:DR
Authorized Official - First Name:LACRETIA
Authorized Official - Middle Name:
Authorized Official - Last Name:BELL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:218-626-4473
Mailing Address - Street 1:237 MEDICAL SCHOOL
Mailing Address - Street 2:1035 UNIVERSITY DRIVE
Mailing Address - City:DULUTH
Mailing Address - State:MN
Mailing Address - Zip Code:55812-3031
Mailing Address - Country:US
Mailing Address - Phone:218-726-7386
Mailing Address - Fax:218-726-7559
Practice Address - Street 1:1035 UNIVERSITY DR
Practice Address - Street 2:237 MEDICAL SCHOOL
Practice Address - City:DULUTH
Practice Address - State:MN
Practice Address - Zip Code:55812-3031
Practice Address - Country:US
Practice Address - Phone:218-726-7386
Practice Address - Fax:218-726-7559
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-21
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Single Specialty