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Search › Minnesota › 101YA0400X

Evan Tharaldson, BA LADC

NPI 1720681984 · on the registry since 2020 · sole proprietor

Practice

Address
1246 University Ave W
Saint Paul, MN 55104
Phone
(651) 333-4368
Fax
(651) 666-2914
Organisation at this address
Key Corp
Wild River Services
Inferred from a shared address, not stated in the registry.
Clinicians at this address
37

Registry record

Primary taxonomy
101YA0400X
101YA0400X
Licence states on file
MN
From the registry's licence fields, which are often incomplete.
Sex
Male
Record last updated
2020-11-19

Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Minnesota