Individual
DR. SHANNON MAURA TASSAVA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PHD
Contact information
Practice address
1716 SUNSET DR, NORTHFIELD, MN 55057-3237
(507) 581-4702
Mailing address
1716 SUNSET DR, NORTHFIELD, MN 55057-3237
(507) 581-4702
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
LP4343
MN
Other
Enumeration date
08/19/2019
Last updated
08/19/2019
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