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General NPI Number Information
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NPI Number | 1245377886
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Entity Type | Organization
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Legal Business Name | TENNISON CONSULTING LLC
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Dates
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Enumeration Date | 01/31/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 897 SAINT PAUL AVE
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City | SAINT PAUL
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State | MN
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Zip | 55116-2015
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Country | US
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Telephone | 612-963-7995
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Fax | 651-698-4817
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Provider Business Mailing Address
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Address Line | 897 SAINT PAUL AVE
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City | SAINT PAUL
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State | MN
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Zip | 55116-2015
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Country | US
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Telephone | 612-963-7995
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Fax | 651-698-4817
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Authorized Official
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Title or Position | THERAPIST
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Name | MS. DANA MARIE TENNISON
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Credential | LMFT
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Telephone | 612-963-7995
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | 1377
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License Number State | MN
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