Provider Demographics
NPI:1831709468
Name:TVETEN, REBECCA ANITA
Entity type:Individual
Prefix:
First Name:REBECCA
Middle Name:ANITA
Last Name:TVETEN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10505 WAYZATA BLVD STE 203-3
Mailing Address - Street 2:
Mailing Address - City:MINNETONKA
Mailing Address - State:MN
Mailing Address - Zip Code:55305-1502
Mailing Address - Country:US
Mailing Address - Phone:651-252-8001
Mailing Address - Fax:866-318-3073
Practice Address - Street 1:10505 WAYZATA BLVD STE 203-3
Practice Address - Street 2:
Practice Address - City:MINNETONKA
Practice Address - State:MN
Practice Address - Zip Code:55305-1502
Practice Address - Country:US
Practice Address - Phone:651-252-8001
Practice Address - Fax:866-318-3073
Is Sole Proprietor?:No
Enumeration Date:2020-08-07
Last Update Date:2023-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker