Provider Demographics
NPI:1609185743
Name:MANN, RACHAEL KRISTINE (LMFT)
Entity Type:Individual
Prefix:
First Name:RACHAEL
Middle Name:KRISTINE
Last Name:MANN
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:RACHAEL
Other - Middle Name:KRISTINE
Other - Last Name:FREEDLAND
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:7580 160TH ST W
Mailing Address - Street 2:
Mailing Address - City:LAKEVILLE
Mailing Address - State:MN
Mailing Address - Zip Code:55044-8348
Mailing Address - Country:US
Mailing Address - Phone:952-239-0486
Mailing Address - Fax:952-435-6797
Practice Address - Street 1:7580 160TH ST W
Practice Address - Street 2:
Practice Address - City:LAKEVILLE
Practice Address - State:MN
Practice Address - Zip Code:55044-8348
Practice Address - Country:US
Practice Address - Phone:952-239-0486
Practice Address - Fax:952-435-6797
Is Sole Proprietor?:No
Enumeration Date:2010-10-06
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
246XS1301X
MN3523106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No246XS1301XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist CardiovascularSonography