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Individual

SANDRA LEE SHEARER

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
MSW, LP

Contact information

Practice address
7362 UNIVERSITY AVE NE, SUITE 209, FRIDLEY, MN 55432-3142
(651) 747-7862
(763) 571-4231
Mailing address
748 ROSELAWN AVE E, SAINT PAUL, MN 55117-2244
(651) 747-7862
(763) 571-4231

Taxonomy

Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
LP2425
MN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
287748100
MN
Enumeration date
09/20/2006
Last updated
06/24/2010
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