| Tanglefish Emotional Healing Llc | |
|
821 Raymond Ave Ste 300 Saint Paul MN 55114-1525 | |
| (612) 213-4510 | |
| (612) 361-5464 |
| Full Name | Tanglefish Emotional Healing Llc |
|---|---|
| Speciality | Clinic/Center |
| Location | 821 Raymond Ave Ste 300, Saint Paul, Minnesota |
| Authorized Official Name and Position | Andrea E Grey (OWNER) |
| Authorized Official Contact | 6122134510 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Tanglefish Emotional Healing Llc 821 Raymond Ave Ste 300 Saint Paul MN 55114-1525 Ph: (612) 213-4510 | Tanglefish Emotional Healing Llc 821 Raymond Ave Ste 300 Saint Paul MN 55114-1525 Ph: (612) 213-4510 |
| NPI Number | 1003555046 |
|---|---|
| Provider Enumeration Date | 05/28/2022 |
| Last Update Date | 03/06/2024 |
| Certification Date | 03/06/2024 |
| Medicare PECOS PAC ID | 9830536309 |
|---|---|
| Medicare Enrollment ID | O20240319003637 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1003555046 | NPI | - | NPPES |
| 1982258125 | Other | MN | NPI 1 |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0850X | Clinic/center - Adult Mental Health | (* (Not Available)) | Primary |
| Provider Name | Andrea E Grey |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1982258125 PECOS PAC ID: 9436582624 Enrollment ID: I20191202000741 |
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