Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103G00000X | Clinical Psychologist | LP5137 | MN |
Y | 103TC0700X | Clinical Psychologist | LP5137 | MN |
NPI | 1003149717 |
---|---|
Provider Name | Dr. Tamarind Knutson |
First Address | Saint Paul, MN 55112-0025 |
Second Address | Saint Paul, MN 55108-5298 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 13/09/2009 |
Last Update Date | 11/04/2010 |