Individual
MRS. SHERIE LYNN CARLSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PHD, LP
Contact information
Practice address
324 BROADWAY ST, STE 206, ALEXANDRIA, MN 56308-1482
(320) 762-1762
(320) 762-0796
Mailing address
24599 165TH ST, GLENWOOD, MN 56334
(320) 491-7783
(320) 762-0796
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
LP3982
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
136937
BHP
—
01
—
218G2MA
BLUE CROSS BLUE SHIELD
MN
01
—
6267225
UBH
—
01
—
936488900
PRIMEWEST HEALTH SYSTEMS
MN
05
—
936488900
—
MN
Enumeration date
11/06/2006
Last updated
10/25/2016
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