Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 111N00000X | Chiropractor | 4729 | MN |
N | 175F00000X | Naturopath | 099.0086731 | VT |
Y | 175F00000X | Naturopath | 1046 | MN |
NPI | 1144318411 |
---|---|
Provider Name | Tamara Ann Sukup Darragh |
First Address | Saint Paul, MN 55127-6162 |
Second Address | Saint Paul, MN 55127-6162 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 11/10/2006 |
Last Update Date | 19/03/2020 |