Provider Demographics
NPI:1417317504
Name:KRUSZKA, ROCHELLE (MA, LMFT)
Entity Type:Individual
Prefix:
First Name:ROCHELLE
Middle Name:
Last Name:KRUSZKA
Suffix:
Gender:F
Credentials:MA, LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7064 W POINT DOUGLAS RD S
Mailing Address - Street 2:SUITE 201
Mailing Address - City:COTTAGE GROVE
Mailing Address - State:MN
Mailing Address - Zip Code:55016-2680
Mailing Address - Country:US
Mailing Address - Phone:651-458-5224
Mailing Address - Fax:
Practice Address - Street 1:721 COMMERCE DRIVE
Practice Address - Street 2:
Practice Address - City:WOODBURY
Practice Address - State:MN
Practice Address - Zip Code:55125
Practice Address - Country:US
Practice Address - Phone:651-424-4000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-03-02
Last Update Date:2019-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN3345106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist