Healthcare Provider Details

I. General information

NPI: 1942084280
Provider Name (Legal Business Name): SABARIIN A HIDIG
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/18/2023
Last Update Date: 08/18/2023
Certification Date: 08/18/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3041 PILLSBURY AVE S
MINNEAPOLIS MN
55408-3184
US

IV. Provider business mailing address

3041 PILLSBURY AVE S
MINNEAPOLIS MN
55408-3184
US

V. Phone/Fax

Practice location:
  • Phone: 612-532-0888
  • Fax:
Mailing address:
  • Phone: 612-532-0888
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TS0200X
TaxonomySchool Psychologist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: