Provider Demographics
NPI:1629363395
Name:KRENZ, REBECCA ANN (LMFT)
Entity type:Individual
Prefix:
First Name:REBECCA
Middle Name:ANN
Last Name:KRENZ
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8085 WAYZATA BLVD STE 215
Mailing Address - Street 2:
Mailing Address - City:MINNEAPOLIS
Mailing Address - State:MN
Mailing Address - Zip Code:55426-1457
Mailing Address - Country:US
Mailing Address - Phone:612-351-0427
Mailing Address - Fax:651-493-2798
Practice Address - Street 1:8085 WAYZATA BLVD STE 215
Practice Address - Street 2:
Practice Address - City:GOLDEN VALLEY
Practice Address - State:MN
Practice Address - Zip Code:55426-1457
Practice Address - Country:US
Practice Address - Phone:612-351-0427
Practice Address - Fax:651-493-2798
Is Sole Proprietor?:Yes
Enumeration Date:2011-06-10
Last Update Date:2024-01-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
106H00000X
WI904-124106H00000X
MN3974106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI1629363395Medicaid