Provider Demographics
NPI:1942562517
Name:FRANTZEN, TESSA LYNN (BS LADC)
Entity Type:Individual
Prefix:MRS
First Name:TESSA
Middle Name:LYNN
Last Name:FRANTZEN
Suffix:
Gender:F
Credentials:BS LADC
Other - Prefix:MS
Other - First Name:TESSA
Other - Middle Name:
Other - Last Name:LOMNES-KULZER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:BS LADC
Mailing Address - Street 1:3329 UNIVERSITY AVE SE
Mailing Address - Street 2:
Mailing Address - City:MINNEAPOLIS
Mailing Address - State:MN
Mailing Address - Zip Code:55414-3325
Mailing Address - Country:US
Mailing Address - Phone:612-454-2268
Mailing Address - Fax:
Practice Address - Street 1:3329 UNIVERSITY AVE SE
Practice Address - Street 2:
Practice Address - City:MINNEAPOLIS
Practice Address - State:MN
Practice Address - Zip Code:55414-3325
Practice Address - Country:US
Practice Address - Phone:612-454-2268
Practice Address - Fax:612-252-0308
Is Sole Proprietor?:No
Enumeration Date:2012-06-11
Last Update Date:2014-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN303280101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)