Individual
CHERYL A HYSJULIEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PSYD LP
Contact information
Practice address
100 4TH ST S, FARGO, ND 58103-1929
(701) 234-3100
Mailing address
100 4TH ST S, FARGO, ND 58103-1929
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
468
ND
103T00000X
Psychologist
LP4019
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
285707300
—
MN
Enumeration date
05/09/2006
Last updated
10/05/2012
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