Individual
TANYA IBRAGIC
Active
Individual
TANYA IBRAGIC
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LP
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
LP3559
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
6267719
MEDICA CHOICE
MN
01
—
94791
OPTUM
MN
01
—
99D54IB
BCBS
MN
01
—
HP27426
HEALTHPARTNERS
MN
Enumeration date
11/24/2006
Last updated
07/08/2007
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