Individual
MISS TAMRA RAE DEVAULT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
409 3RD ST NE SUITE B, CASS LAKE, MN 56633
(218) 335-3567
(218) 335-2482
Mailing address
190 SAILSTAR DR NE, CASS LAKE, MN 56633-3565
(218) 335-3567
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
307444
MN
246RP1900X
Phlebotomy Technician
Primary
—
—
Other
Enumeration date
04/26/2007
Last updated
02/27/2026
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