Individual
SHAIDA VAFAEI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MA
Contact information
Practice address
8500 210TH ST W, LAKEVILLE, MN 55044-5707
(952) 484-2211
Mailing address
2801 GIRARD AVE S APT 304, MINNEAPOLIS, MN 55408-2048
(952) 484-2211
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000000
NO NPI YET
—
Enumeration date
09/18/2018
Last updated
09/18/2018
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