Individual
DAVID E TUPPER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHD, LP
Contact information
Practice address
701 PARK AVE, MINNEAPOLIS, MN 55415-1623
(612) 873-2599
(612) 904-4303
Mailing address
701 PARK AVE, MINNEAPOLIS, MN 55415-1623
(612) 873-6005
(612) 630-8242
Taxonomy
Speciality
Code
Description
License number
State
103G00000X
Clinical Neuropsychologist
Primary
LP2193
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
152299
BEHAVIORAL HEALTHCARE
MN
01
—
37A22TU
BLUE CROSS BLUE SHIELD
MN
01
—
61-56994
UNITED BEHAVIORAL HEALTH
MN
Enumeration date
06/21/2006
Last updated
11/28/2007
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