Provider Information for 1699012625
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Mrs. NATALEE RACHELE TANGEN MSW, LICSW
Sex: Female
NPI: 1699012625
Last Updated: 2025-01-07
Certification Date: 2025-01-07
Certification Date: 2025-01-07
Details
| Name | Value | ||||||||
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| NPI | 1699012625 | ||||||||
| Enumeration Date | 2013-01-10 | ||||||||
| NPI Type | NPI-1 Individual | ||||||||
| Sole Proprietor | NO | ||||||||
| Status | Active | ||||||||
| Mailing Address | 1077 CHURCHILL CIR SHOREVIEW, MN 55126-5902 United States Phone: 701-260-6172 | Fax: | ||||||||
| Primary Practice Address | 1077 CHURCHILL CIR SHOREVIEW, MN 55126-5902 United States Phone: 701-260-6172 | Fax: | ||||||||
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