Provider Demographics
NPI:1285309237
Name:STAPELMANN, TESSA (PSYD, LP)
Entity type:Individual
Prefix:
First Name:TESSA
Middle Name:
Last Name:STAPELMANN
Suffix:
Gender:F
Credentials:PSYD, LP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7400 METRO BLVD STE 390
Mailing Address - Street 2:
Mailing Address - City:EDINA
Mailing Address - State:MN
Mailing Address - Zip Code:55439-2358
Mailing Address - Country:US
Mailing Address - Phone:952-955-4714
Mailing Address - Fax:
Practice Address - Street 1:7400 METRO BLVD STE 390
Practice Address - Street 2:
Practice Address - City:EDINA
Practice Address - State:MN
Practice Address - Zip Code:55439-2358
Practice Address - Country:US
Practice Address - Phone:952-955-4714
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-08-11
Last Update Date:2023-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MNLP6891103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical