| Tarriance, Llc | |
|
4756 Banning Ave Ste 208 White Bear Lake MN 55110-3206 | |
| (651) 468-6350 | |
| Not Available |
| Full Name | Tarriance, Llc |
|---|---|
| Speciality | Counselor - Professional |
| Location | 4756 Banning Ave Ste 208, White Bear Lake, Minnesota |
| Authorized Official Name and Position | Kathleen Johnson (CLINICAL COUNSELOR) |
| Authorized Official Contact | 6514686350 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Tarriance, Llc 207 Kenwood Dr W Maplewood MN 55117-2527 Ph: (651) 468-6350 | Tarriance, Llc 4756 Banning Ave Ste 208 White Bear Lake MN 55110-3206 Ph: (651) 468-6350 |
| NPI Number | 1639821424 |
|---|---|
| Provider Enumeration Date | 01/22/2022 |
| Last Update Date | 01/22/2022 |
| Certification Date | 01/22/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1639821424 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YP2500X | Counselor - Professional | (* (Not Available)) | Primary |
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