Individual
CHERYL GOLDENBERG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PSYD, LP
Contact information
Practice address
5100 GAMBLE DR STE 100, SAINT LOUIS PARK, MN 55416-1582
(952) 541-2500
(952) 541-2539
Mailing address
8170 33RD AVE, MS: 21110Q, BLOOMINGTON, MN 55425-4516
(952) 541-2500
(952) 541-2539
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
4072
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
518514900
—
MN
Enumeration date
09/22/2006
Last updated
10/11/2016
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