Healthcare Provider Details

I. General information

NPI: 1881506269
Provider Name (Legal Business Name): SHEILA DIEP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/21/2026
Last Update Date: 09/21/2026
Certification Date: 09/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4402 HAINES RD STE 1
DULUTH MN
55811-2852
US

IV. Provider business mailing address

133 SUMMIT ST APT 122
DULUTH MN
55803-4516
US

V. Phone/Fax

Practice location:
  • Phone: 218-279-8364
  • Fax:
Mailing address:
  • Phone: 425-501-2842
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: