Provider Demographics
NPI:1871123125
Name:DUPAUL, RACHEL M (PHD, LP)
Entity type:Individual
Prefix:DR
First Name:RACHEL
Middle Name:M
Last Name:DUPAUL
Suffix:
Gender:F
Credentials:PHD, LP
Other - Prefix:DR
Other - First Name:RACHEL
Other - Middle Name:M
Other - Last Name:HAUG
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PHD, LP
Mailing Address - Street 1:13055 RIVERDALE DR NW STE 500
Mailing Address - Street 2:
Mailing Address - City:COON RAPIDS
Mailing Address - State:MN
Mailing Address - Zip Code:55448-8414
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:13055 RIVERDALE DR NW STE 500
Practice Address - Street 2:
Practice Address - City:COON RAPIDS
Practice Address - State:MN
Practice Address - Zip Code:55448-8414
Practice Address - Country:US
Practice Address - Phone:763-294-9957
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-01-24
Last Update Date:2024-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MNLP6502103TC1900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounseling