Individual
DR. JUDY TIESEL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PH.D
Contact information
Practice address
7400 METRO BLVD, SUITE 413, EDINA, MN 55439-2316
(952) 835-6950
(952) 835-0072
Mailing address
7400 METRO BLVD, SUITE 413, EDINA, MN 55439-2316
(952) 835-6950
(952) 835-0072
Taxonomy
Speciality
Code
Description
License number
State
103TF0000X
Family Psychologist
Primary
3280
MN
106H00000X
Marriage & Family Therapist
870
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
6299691
—
MN
01
—
8H911T1
BLUE CROSS-BLUESHIELD
MN
Enumeration date
05/04/2007
Last updated
09/11/2025
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