Provider Demographics
NPI:1629648118
Name:SCHELHAAS, JOSEPHINE REYES (PSYCHOLOGY GRADUATE)
Entity Type:Individual
Prefix:MRS
First Name:JOSEPHINE
Middle Name:REYES
Last Name:SCHELHAAS
Suffix:
Gender:F
Credentials:PSYCHOLOGY GRADUATE
Other - Prefix:
Other - First Name:JOSEPHINE
Other - Middle Name:CARDONA
Other - Last Name:REYES
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2419 WASHINGTON AVE
Mailing Address - Street 2:
Mailing Address - City:MONTEVIDEO
Mailing Address - State:MN
Mailing Address - Zip Code:56265-2619
Mailing Address - Country:US
Mailing Address - Phone:320-877-7074
Mailing Address - Fax:
Practice Address - Street 1:1314 NORTH HIAWATHA
Practice Address - Street 2:
Practice Address - City:PIPESTONE
Practice Address - State:MN
Practice Address - Zip Code:56164-2282
Practice Address - Country:US
Practice Address - Phone:507-825-5858
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-06-28
Last Update Date:2021-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician