Individual
TAHSI PO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
500 GROTTO ST N, SAINT PAUL, MN 55104-1754
(651) 760-3236
Mailing address
500 GROTTO ST N, SAINT PAUL, MN 55104-1754
(651) 760-3236
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
10/31/2016
Last updated
10/31/2016
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