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General NPI Number Information
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NPI Number | 1902697279
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Entity Type | Individual
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Provider Name | MICHAEL WILLIAM TINDALL LP
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Gender | Male
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Dates
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Enumeration Date | 05/15/2025
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Last Update Date | 05/15/2025
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Provider Practice Location Address
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Address Line | 992 INWOOD AVE N
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City | OAKDALE
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State | MN
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Zip | 55128-6625
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Country | US
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Telephone | 651-472-5915
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Fax |
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Provider Business Mailing Address
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Address Line | 800 GRAMSIE RD
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City | SHOREVIEW
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State | MN
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Zip | 55126-2902
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Country | US
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Telephone | 507-261-9826
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103T00000X
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Taxonomy Name | Psychologist
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License Number | LP7193
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License Number State | MN
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