Provider Demographics
NPI:1710992243
Name:TUORILA, JAMES RUDOLPH
Entity Type:Individual
Prefix:
First Name:JAMES
Middle Name:RUDOLPH
Last Name:TUORILA
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:103 DOCTORS PARK
Mailing Address - Street 2:
Mailing Address - City:SAINT CLOUD
Mailing Address - State:MN
Mailing Address - Zip Code:56303-1207
Mailing Address - Country:US
Mailing Address - Phone:320-253-4321
Mailing Address - Fax:320-281-3045
Practice Address - Street 1:103 DOCTORS PARK
Practice Address - Street 2:
Practice Address - City:SAINT CLOUD
Practice Address - State:MN
Practice Address - Zip Code:56303-1207
Practice Address - Country:US
Practice Address - Phone:320-253-4321
Practice Address - Fax:320-281-3045
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-31
Last Update Date:2019-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
103T00000X
MNLP1576103TC1900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounseling
No103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN114570OtherUCARE GROUP
MN115382OtherBEHAVIORAL HEALTH
MN6171924OtherMEDICA
MN915850200OtherMEDICAL ASSISTANCE
MN28Q55TUOtherBLUE CROSS INDIV
MN6171924OtherMEDICA
MN28Q49CEOtherBLUE CROSS GROUP