Provider Demographics
NPI:1740948801
Name:PUMPER, RYLEE (LICSW)
Entity type:Individual
Prefix:
First Name:RYLEE
Middle Name:
Last Name:PUMPER
Suffix:
Gender:F
Credentials:LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1702 MILLER TRUNK HWY STE 214
Mailing Address - Street 2:
Mailing Address - City:DULUTH
Mailing Address - State:MN
Mailing Address - Zip Code:55811-4448
Mailing Address - Country:US
Mailing Address - Phone:952-486-2761
Mailing Address - Fax:
Practice Address - Street 1:1702 MILLER TRUNK HWY STE 214
Practice Address - Street 2:
Practice Address - City:DULUTH
Practice Address - State:MN
Practice Address - Zip Code:55811-4448
Practice Address - Country:US
Practice Address - Phone:218-727-3888
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-12-06
Last Update Date:2023-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical