Provider Demographics
NPI:1326597287
Name:NDOSI, REBEKA (LAC, DIPLAC)
Entity Type:Individual
Prefix:MS
First Name:REBEKA
Middle Name:
Last Name:NDOSI
Suffix:
Gender:F
Credentials:LAC, DIPLAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:224 W FRANKLIN AVE
Mailing Address - Street 2:
Mailing Address - City:MINNEAPOLIS
Mailing Address - State:MN
Mailing Address - Zip Code:55404-2331
Mailing Address - Country:US
Mailing Address - Phone:612-824-0037
Mailing Address - Fax:
Practice Address - Street 1:224 W FRANKLIN AVE
Practice Address - Street 2:
Practice Address - City:MINNEAPOLIS
Practice Address - State:MN
Practice Address - Zip Code:55404-2331
Practice Address - Country:US
Practice Address - Phone:612-824-0037
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-10-03
Last Update Date:2016-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN1363171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist