Provider Demographics
NPI:1396133013
Name:SAUNDERS, TINA (MA, LMFT)
Entity type:Individual
Prefix:
First Name:TINA
Middle Name:
Last Name:SAUNDERS
Suffix:
Gender:F
Credentials:MA, LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12415 53RD AVE N
Mailing Address - Street 2:
Mailing Address - City:PLYMOUTH
Mailing Address - State:MN
Mailing Address - Zip Code:55442-2050
Mailing Address - Country:US
Mailing Address - Phone:612-269-0168
Mailing Address - Fax:
Practice Address - Street 1:6465 WAYZATA BLVD STE 710
Practice Address - Street 2:
Practice Address - City:ST LOUIS PARK
Practice Address - State:MN
Practice Address - Zip Code:55426-1733
Practice Address - Country:US
Practice Address - Phone:612-269-0168
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-01-05
Last Update Date:2024-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN3022106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist