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Individual

SHERI LYNN DELICH

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
5284 TAYLOR ST NE, FRIDLEY, MN 55421-1857
(651) 500-1838
Mailing address
5284 TAYLOR ST NE, FRIDLEY, MN 55421-1857
(651) 500-1838

Taxonomy

Speciality
Code
Description
License number
State
172A00000X
Driver
Primary
R558120061918
MN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
00823837
CASE NUMBER
MN
01
00876171
MHCP MEMBER NUMBER
MN
01
X102141
WORKER ID
MN
Enumeration date
03/08/2016
Last updated
03/08/2016
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