Provider Demographics
NPI:1003149717
Name:KNUTSON, TAMARIND (PSYD, LP)
Entity Type:Individual
Prefix:DR
First Name:TAMARIND
Middle Name:
Last Name:KNUTSON
Suffix:
Gender:F
Credentials:PSYD, LP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 120836
Mailing Address - Street 2:
Mailing Address - City:SAINT PAUL
Mailing Address - State:MN
Mailing Address - Zip Code:55112-0025
Mailing Address - Country:US
Mailing Address - Phone:651-646-8985
Mailing Address - Fax:
Practice Address - Street 1:1360 ENERGY PARK DR STE 340
Practice Address - Street 2:
Practice Address - City:SAINT PAUL
Practice Address - State:MN
Practice Address - Zip Code:55108-5298
Practice Address - Country:US
Practice Address - Phone:651-646-8985
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-09-13
Last Update Date:2010-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MNLP5137103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical