Individual
SELAMAWIT ELIZABETH SHANNON-TAMRAT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
5775 WAYZATA BLVD STE 700, ST LOUIS PARK, MN 55416-1233
(763) 312-1878
Mailing address
5775 WAYZATA BLVD STE 700, ST LOUIS PARK, MN 55416-1233
(763) 312-1878
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
STUDENT
MN
103K00000X
Behavior Analyst
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
47-40144022
—
MN
Enumeration date
04/26/2019
Last updated
05/20/2021
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