Individual
SHARON R KOUKKARI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.S., L.P.
Contact information
Practice address
5354 PARKDALE DR, SUITE 300, ST LOUIS PARK, MN 55416-1603
(612) 889-1692
Mailing address
5354 PARKDALE DR, SUITE 300, ST LOUIS PARK, MN 55416-1603
(612) 889-1692
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
LP1444
MN
Other
Enumeration date
10/27/2009
Last updated
10/27/2009
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