Provider Demographics
NPI:1609214634
Name:DYKOSKI, RHEA MARIE (LAC, DIPLOM)
Entity Type:Individual
Prefix:MS
First Name:RHEA
Middle Name:MARIE
Last Name:DYKOSKI
Suffix:
Gender:F
Credentials:LAC, DIPLOM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:516 DRIFTWOOD RD
Mailing Address - Street 2:
Mailing Address - City:NEW BRIGHTON
Mailing Address - State:MN
Mailing Address - Zip Code:55112-2567
Mailing Address - Country:US
Mailing Address - Phone:651-214-5525
Mailing Address - Fax:
Practice Address - Street 1:24000 HIGHWAY 7
Practice Address - Street 2:
Practice Address - City:EXCELSIOR
Practice Address - State:MN
Practice Address - Zip Code:55331-2939
Practice Address - Country:US
Practice Address - Phone:952-474-3016
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-06-12
Last Update Date:2013-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN1618171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist