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Individual

TAI J MENDENHALL

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
LMFT, PHD

Contact information

Practice address
1414 MARYLAND AVE E, SAINT PAUL, MN 55106-2824
(651) 772-3461
(651) 772-2605
Mailing address
1414 MARYLAND AVE E, SAINT PAUL, MN 55106-2824
(651) 772-3461
(651) 772-2605

Taxonomy

Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
Primary
1318
MN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
026
TRIWEST
MN
01
1042738
PREFERRED ONE
MN
01
124040
UCARE
MN
01
270K3ME
BCBS MN NUMBER
MN
01
62-53752
UBH/MEDICA NUMBER
MN
01
HP42677
HEALTHPARTNERS
MN
Enumeration date
08/23/2006
Last updated
07/09/2007
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