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Individual

MS. SHARON M DAVERN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
MSED

Contact information

Practice address
1001 14TH ST NW, ROCHESTER, MN 55901-2590
(507) 534-2668
(507) 540-1290
Mailing address
3 FOX RIDGE PT, TAYLORS, SC 29687-6406
(507) 534-2668
(507) 540-1290

Taxonomy

Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
LP2103
MN
106H00000X
Marriage & Family Therapist
Primary
2
MN
106H00000X
Marriage & Family Therapist
692
TN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
018669000
TN
01
3K149DA
BC/BS
MN
05
896350900
MN
Enumeration date
01/13/2006
Last updated
04/04/2022
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