Provider Demographics
NPI:1306157680
Name:HAKANSON, RACHEL M (DPT)
Entity type:Individual
Prefix:
First Name:RACHEL
Middle Name:M
Last Name:HAKANSON
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:RACHEL
Other - Middle Name:M
Other - Last Name:BERGLUND
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DPT
Mailing Address - Street 1:18912 LAKE DR E
Mailing Address - Street 2:
Mailing Address - City:CHANHASSEN
Mailing Address - State:MN
Mailing Address - Zip Code:55317-9348
Mailing Address - Country:US
Mailing Address - Phone:952-908-2730
Mailing Address - Fax:952-908-3731
Practice Address - Street 1:18912 LAKE DR E
Practice Address - Street 2:
Practice Address - City:CHANHASSEN
Practice Address - State:MN
Practice Address - Zip Code:55317-9348
Practice Address - Country:US
Practice Address - Phone:952-908-2730
Practice Address - Fax:952-908-3731
Is Sole Proprietor?:No
Enumeration Date:2010-07-01
Last Update Date:2010-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN8548OtherLICENSE