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TIMOTHY PAUL TINIUS PHD

Clinical Neuropsychologist

Sauk Rapids, Minnesota

Provider NPI: 1356452163

Provider Information:
 TIMOTHY PAUL TINIUS PHD
Gender: M
Not Sole Proprietor

Practice Location:
225 N BENTON DR SUITE 104 SAUK RAPIDS, MN 56379 US
Tel: 320-654-9311  Fax: 320-654-9248

Business Mailing Address:
225 N BENTON DR SUITE 104 SAUK RAPIDS, MN 56379 US
Tel: 320-654-9311  Fax: 320-654-9248

Entity Type: Individual

Taxonomy:

PrimaryCodeCategory/DescriptionStateLicense Number
X103G00000XBehavioral Health & Social Service Providers
Clinical Neuropsychologist
MNLP 0251
X103TC0700XBehavioral Health & Social Service Providers
Psychologist
MNLP 0251
X103TF0200XBehavioral Health & Social Service Providers
Psychologist
MNLP 0251

Other Provider Identifiers:

IssuerNumberStateType
MEDICA PIN61-21170MN01
BCBS PROVIDER PIN075J1TI 075J6TIMN01
Code values:
01, Other | 02, Medicare Upin | 04, Medicare Id-Type Unspecified
05, Medicaid | 06, Medicare Oscar/Certification | 07, Medicare NSC | 08, Medicare Pin







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