Provider Demographics
NPI:1346068087
Name:GENDLER, REBECA EMILY
Entity type:Individual
Prefix:
First Name:REBECA
Middle Name:EMILY
Last Name:GENDLER
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 1:3431 ELLIOT AVE
Mailing Address - Street 2:
Mailing Address - City:MINNEAPOLIS
Mailing Address - State:MN
Mailing Address - Zip Code:55407-2126
Mailing Address - Country:US
Mailing Address - Phone:952-649-7154
Mailing Address - Fax:
Practice Address - Street 1:12301 WHITEWATER DR STE 101
Practice Address - Street 2:
Practice Address - City:MINNETONKA
Practice Address - State:MN
Practice Address - Zip Code:55343-4157
Practice Address - Country:US
Practice Address - Phone:952-999-6097
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-10-01
Last Update Date:2024-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health