Individual
DR. RUTH TALLAKSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PH.D., L.P.
Contact information
Practice address
91 SNELLING AVE N, SUITE 220, SAINT PAUL, MN 55104-6753
(651) 647-1001
(651) 647-6111
Mailing address
91 SNELLING AVE N, SUITE 220, SAINT PAUL, MN 55104-6753
(651) 647-1001
(651) 647-6111
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
LP0208
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
25094
AMERICA'S PPO
MN
01
—
6H601TA
BLUE CROSS BLUE SHIELD
MN
Enumeration date
10/10/2006
Last updated
07/08/2007
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