| Tamarind P Knutson, Llc | |
|
2579 Hamline Ave N Ste D Roseville MN 55113-3187 | |
| (651) 398-7882 | |
| Not Available |
| Full Name | Tamarind P Knutson, Llc |
|---|---|
| Speciality | Psychologist |
| Location | 2579 Hamline Ave N Ste D, Roseville, Minnesota |
| Authorized Official Name and Position | Tamarind P Knutson (LICENSED PSYCHOLOGIST) |
| Authorized Official Contact | 6513987882 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Tamarind P Knutson, Llc 2579 Hamline Ave N Ste D Roseville MN 55113-3187 Ph: () - | Tamarind P Knutson, Llc 2579 Hamline Ave N Ste D Roseville MN 55113-3187 Ph: (651) 398-7882 |
| NPI Number | 1760815229 |
|---|---|
| Provider Enumeration Date | 08/19/2013 |
| Last Update Date | 08/19/2013 |
| Medicare PECOS PAC ID | 3476782855 |
|---|---|
| Medicare Enrollment ID | O20140205000489 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1760815229 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TC0700X | Psychologist - Clinical | LP5137 (Minnesota) | Primary |
| Provider Name | Tamarind P Knutson |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1003149717 PECOS PAC ID: 7416086566 Enrollment ID: I20100527000453 |
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