Healthcare Provider Details

I. General information

NPI: 1760396923
Provider Name (Legal Business Name): SARAH BUXTON
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/02/2026
Last Update Date: 10/02/2026
Certification Date: 10/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

701 COUNTY ROAD B W
ROSEVILLE MN
55113-4526
US

IV. Provider business mailing address

701 COUNTY ROAD B W
ROSEVILLE MN
55113-4526
US

V. Phone/Fax

Practice location:
  • Phone: 651-487-4397
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TS0200X
TaxonomySchool Psychologist
License Number437656
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: