Organization
RUTH H. TALLAKSON, PHD, LP, LTD.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. RUTH TALLAKSON PHD, LP (PRESIDENT)
(651) 647-1001
Entity
Organization
Contact information
Practice address
91 SNELLING AVE N, SUITE 220, SAINT PAUL, MN 55104-6753
(651) 647-1001
(651) 647-6111
Mailing address
91 SNELLING AVE N, SUITE 220, SAINT PAUL, MN 55104-6753
(651) 647-1001
(651) 647-6111
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
LP0208
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
25094
AMERICA'S PPO
MN
01
—
6H601TA
BLUE CROSS BLUE SHIELD
MN
Enumeration date
10/10/2006
Last updated
08/22/2020
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