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General NPI Number Information
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NPI Number | 1073980082
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Entity Type | Organization
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Legal Business Name | SARAH DOLL
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Dates
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Enumeration Date | 08/25/2015
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Last Update Date | 08/25/2015
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Provider Practice Location Address
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Address Line | 2100 COUNTY ROAD 42 W
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City | BURNSVILLE
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State | MN
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Zip | 55337-6913
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Country | US
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Telephone | 612-308-3575
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Fax |
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Provider Business Mailing Address
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Address Line | 2100 COUNTY ROAD 42 W
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City | BURNSVILLE
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State | MN
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Zip | 55337-6913
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Country | US
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Telephone | 612-308-3575
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Fax |
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Authorized Official
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Title or Position | PSYCHOTHERAPIST
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Name | MRS. SARAH A DOLL
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Credential | MA, LPCC
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Telephone | 612-308-3575
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | 247
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License Number State | MN
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