Provider Demographics
NPI:1336468503
Name:ROMANELLI, RACHEL RAMSEY (LMP)
Entity Type:Individual
Prefix:
First Name:RACHEL
Middle Name:RAMSEY
Last Name:ROMANELLI
Suffix:
Gender:F
Credentials:LMP
Other - Prefix:
Other - First Name:RACHEL
Other - Middle Name:RAMSEY
Other - Last Name:ROMANELLI
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LMP
Mailing Address - Street 1:3507 W 50TH ST
Mailing Address - Street 2:
Mailing Address - City:MINNEAPOLIS
Mailing Address - State:MN
Mailing Address - Zip Code:55410-2124
Mailing Address - Country:US
Mailing Address - Phone:612-456-7096
Mailing Address - Fax:
Practice Address - Street 1:3507 W 50TH ST
Practice Address - Street 2:
Practice Address - City:MINNEAPOLIS
Practice Address - State:MN
Practice Address - Zip Code:55410-2124
Practice Address - Country:US
Practice Address - Phone:612-456-7096
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-05-26
Last Update Date:2023-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMA#000009603225700000X
225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist