Dr. Diane Louise Stellrecht
Clinical Psychologist Adult Development & Aging Psychologist
4027 County Road 25
Minneapolis
, Minnesota 55416-2629
Dr. Diane Louise Stellrecht
Clinical Psychologist Adult Development & Aging Psychologist
4027 County Road 25
Minneapolis
, Minnesota 55416-2629
(612) 925-8496
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About
Features
Specialties
- Adult Development & Aging Psychologist
- Clinical Psychologist
Languages spoken
- English
Location
First Address
- Dr. Diane Louise Stellrecht
- 4240 Park Glen Rd
- St Louis Park, MN
- Zip : 55416-5427
- Fax : (612) 925-8496
- Phone : (612) 925-6033
Second Address
- Dr. Diane Louise Stellrecht
- 4027 County Road 25
- Minneapolis, MN
- Zip : 55416-2629
- Fax : (612) 925-8496
- Phone : (612) 925-6033
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| N | 103TA0700X | Adult Development & Aging Psychologist | 1130 | MN |
| N | 103G00000X | Clinical Psychologist | 1130 | MN |
| N | 103TC0700X | Clinical Psychologist | 1130 | MN |
| Y | 103G00000X | Clinical Psychologist | LP1130 | MN |
| Y | 103TC0700X | Clinical Psychologist | LP1130 | MN |
National Provider Identifier
| NPI | 1013108075 |
|---|---|
| Provider Name | Dr. Diane Louise Stellrecht |
| First Address | St Louis Park, MN 55416-5427 |
| Second Address | Minneapolis, MN 55416-2629 |
| Gender | F |
| NPI Entity type | Individual |
| Is Sole Proprietor | Yes |
| Is Organization Subpart | N/A |
| Enumeration Date | 06/08/2007 |
| Last Update Date | 22/12/2021 |
Additional Identifiers
| IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
|---|---|---|
| 28682ST | BCBS (01) | MN |
| 588350400 | (05) | MN |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.