Healthcare Provider Details
I. General information
NPI: 1750321782
Provider Name (Legal Business Name): KATHLEEN R. SCHARA PSY.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: X
II. Dates (important events)
Enumeration Date: 06/07/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
126 E ALCOTT AVE
FERGUS FALLS MN
56537-2903
US
IV. Provider business mailing address
516 S OAK ST
FERGUS FALLS MN
56537-2614
US
V. Phone/Fax
- Phone: 218-736-6987
- Fax: 218-736-6980
- Phone:
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 103TC0700X |
| Taxonomy | Clinical Psychologist |
| License Number | LP2028 |
| License Number State | MN |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: