Provider Demographics
NPI:1134720212
Name:PRZEKWAS, RACHEL RENEE (LADC, LSW)
Entity type:Individual
Prefix:
First Name:RACHEL
Middle Name:RENEE
Last Name:PRZEKWAS
Suffix:
Gender:F
Credentials:LADC, LSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:216 CENTER ST W STE 101
Mailing Address - Street 2:
Mailing Address - City:ROSEAU
Mailing Address - State:MN
Mailing Address - Zip Code:56751-1494
Mailing Address - Country:US
Mailing Address - Phone:218-242-2394
Mailing Address - Fax:
Practice Address - Street 1:216 CENTER ST W STE 101
Practice Address - Street 2:
Practice Address - City:ROSEAU
Practice Address - State:MN
Practice Address - Zip Code:56751-1494
Practice Address - Country:US
Practice Address - Phone:218-242-2394
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-11-04
Last Update Date:2020-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN305849101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)