Individual
MS. SUZANNE E DERHEIM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LMFT
Contact information
Practice address
5500 94TH AVE N, BROOKLYN PARK, MN 55443-1992
(763) 762-8835
(763) 315-6678
Mailing address
5500 94TH AVE N, BROOKLYN PARK, MN 55443-1992
(763) 762-8835
(763) 315-6678
Taxonomy
Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
Primary
2849
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
355355800
—
MN
Enumeration date
02/15/2017
Last updated
09/19/2018
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