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Individual

SANDRA FERRELL

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MA, LP

Contact information

Practice address
203 10TH AVE NW, AUSTIN, MN 55912-2909
(507) 437-9085
(507) 437-2393
Mailing address
203 10TH AVE NW, AUSTIN, MN 55912-2909
(507) 437-9085
(507) 437-2393

Taxonomy

Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
LP0498
MN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
385734400
MN
05
385734401
MN
Enumeration date
09/15/2014
Last updated
10/07/2014
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