Provider Demographics
NPI:1235954546
Name:TAUS, REBECCA (MASSAGE THERAPIST)
Entity type:Individual
Prefix:
First Name:REBECCA
Middle Name:
Last Name:TAUS
Suffix:
Gender:F
Credentials:MASSAGE THERAPIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10904 57TH ST NE STE 109
Mailing Address - Street 2:
Mailing Address - City:ALBERTVILLE
Mailing Address - State:MN
Mailing Address - Zip Code:55301-4654
Mailing Address - Country:US
Mailing Address - Phone:763-516-5168
Mailing Address - Fax:
Practice Address - Street 1:10904 57TH ST NE STE 109
Practice Address - Street 2:
Practice Address - City:ALBERTVILLE
Practice Address - State:MN
Practice Address - Zip Code:55301-4654
Practice Address - Country:US
Practice Address - Phone:763-516-5168
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-11-21
Last Update Date:2024-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist