Individual
TARA ANN PERTTULA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MSW
Contact information
Practice address
16180 HASTINGS AVE SE, PRIOR LAKE, MN 55372
(952) 443-4600
(952) 443-4604
Mailing address
16180 HASTINGS AVE SE STE 205, PRIOR LAKE, MN 55372-9228
(952) 443-4600
(952) 443-4604
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
6801096893
MI
Other
Enumeration date
08/20/2014
Last updated
06/27/2018
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