Provider Demographics
NPI:1710323928
Name:NORINE, REBECCA (MHP)
Entity Type:Individual
Prefix:
First Name:REBECCA
Middle Name:
Last Name:NORINE
Suffix:
Gender:F
Credentials:MHP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2432 GIRARD AVE S
Mailing Address - Street 2:
Mailing Address - City:MINNEAPOLIS
Mailing Address - State:MN
Mailing Address - Zip Code:55405-2535
Mailing Address - Country:US
Mailing Address - Phone:612-377-6284
Mailing Address - Fax:
Practice Address - Street 1:2432 GIRARD AVE S
Practice Address - Street 2:
Practice Address - City:MINNEAPOLIS
Practice Address - State:MN
Practice Address - Zip Code:55405-2535
Practice Address - Country:US
Practice Address - Phone:612-377-6284
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-05-14
Last Update Date:2013-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health