Individual
SHARA MARIE WASSERMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CCCSLP
Contact information
Practice address
745 NEWBERRY LN, CHASKA, MN 55318-3216
(952) 448-5205
Mailing address
745 NEWBERRY LN, CHASKA, MN 55318-3216
(952) 448-5205
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
8539
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
12028354
ASHA
—
01
—
8539
MN DEPT OF HEALTH
MN
Enumeration date
02/08/2010
Last updated
02/08/2010
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