Provider Demographics
NPI:1841544921
Name:GIERSDORF, RACHEL I (PSYD LP)
Entity type:Individual
Prefix:MS
First Name:RACHEL
Middle Name:I
Last Name:GIERSDORF
Suffix:
Gender:F
Credentials:PSYD LP
Other - Prefix:
Other - First Name:RACHEL
Other - Middle Name:I
Other - Last Name:LEVITSKY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PSYD LP
Mailing Address - Street 1:1315 E 24TH ST
Mailing Address - Street 2:
Mailing Address - City:MINNEAPOLIS
Mailing Address - State:MN
Mailing Address - Zip Code:55404-3975
Mailing Address - Country:US
Mailing Address - Phone:612-721-9800
Mailing Address - Fax:612-721-7870
Practice Address - Street 1:1315 E 24TH ST
Practice Address - Street 2:
Practice Address - City:MINNEAPOLIS
Practice Address - State:MN
Practice Address - Zip Code:55404-3975
Practice Address - Country:US
Practice Address - Phone:612-721-9800
Practice Address - Fax:612-721-7870
Is Sole Proprietor?:No
Enumeration Date:2012-10-29
Last Update Date:2018-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MNLP5542103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical