Provider Demographics
NPI:1760663546
Name:HUESERS, TAMARA JEAN (LSW)
Entity Type:Individual
Prefix:
First Name:TAMARA
Middle Name:JEAN
Last Name:HUESERS
Suffix:
Gender:F
Credentials:LSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2835 W SAINT GERMAIN ST
Mailing Address - Street 2:SUITE 300
Mailing Address - City:SAINT CLOUD
Mailing Address - State:MN
Mailing Address - Zip Code:56301-5869
Mailing Address - Country:US
Mailing Address - Phone:320-259-4151
Mailing Address - Fax:320-259-5707
Practice Address - Street 1:2835 W SAINT GERMAIN ST
Practice Address - Street 2:SUITE 300
Practice Address - City:SAINT CLOUD
Practice Address - State:MN
Practice Address - Zip Code:56301-5869
Practice Address - Country:US
Practice Address - Phone:320-259-4151
Practice Address - Fax:320-259-5707
Is Sole Proprietor?:No
Enumeration Date:2007-11-20
Last Update Date:2007-11-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN11348104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker