Individual
KATE MCTAVISH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MA
Contact information
Practice address
2265 COMO AVE, SAINT PAUL, MN 55108-1737
(651) 645-5323
Mailing address
2265 COMO AVE, SAINT PAUL, MN 55108-1737
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
07/17/2018
Last updated
10/22/2018
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