Individual
MICHAEL JAMES TANGUAY
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
MA LP
Contact information
Practice address
540 E 1ST ST, WACONIA, MN 55387-1601
(952) 442-4437
(952) 442-3084
Mailing address
540 E 1ST ST, WACONIA, MN 55387-1601
(952) 442-4437
(952) 442-3084
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
LP0250
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0591002
PREFERRED ONE
MN
01
—
102536
U-CARE
MN
01
—
6217253
UBH-MEDICA
MN
01
—
8H285TA
BLUECROSSBLUESHIELD
MN
01
—
HP19046
HEALTH PARTNERS
MN
Enumeration date
08/15/2005
Last updated
07/08/2007
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