Provider Demographics
NPI:1497049019
Name:MARMOR, TAMAR MELMED (MPS, ATR, LMFT)
Entity Type:Individual
Prefix:MRS
First Name:TAMAR
Middle Name:MELMED
Last Name:MARMOR
Suffix:
Gender:F
Credentials:MPS, ATR, LMFT
Other - Prefix:
Other - First Name:TAMAR
Other - Middle Name:
Other - Last Name:MELMED
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1660 HIGHWAY 100 S
Mailing Address - Street 2:SUITE 250
Mailing Address - City:ST LOUIS PARK
Mailing Address - State:MN
Mailing Address - Zip Code:55416-1529
Mailing Address - Country:US
Mailing Address - Phone:651-645-5323
Mailing Address - Fax:952-746-5962
Practice Address - Street 1:1660 HIGHWAY 100 S
Practice Address - Street 2:SUITE 250
Practice Address - City:ST LOUIS PARK
Practice Address - State:MN
Practice Address - Zip Code:55416-1529
Practice Address - Country:US
Practice Address - Phone:651-645-5323
Practice Address - Fax:952-746-5962
Is Sole Proprietor?:No
Enumeration Date:2011-05-31
Last Update Date:2011-05-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN2305106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist