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General NPI Number Information
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NPI Number | 1689826158
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Entity Type | Individual
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Provider Name | SHEILA MALAND LP
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Gender | Female
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Dates
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Enumeration Date | 10/16/2008
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Last Update Date | 08/26/2016
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Provider Practice Location Address
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Address Line | 311 RAMSEY ST STE 205
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City | SAINT PAUL
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State | MN
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Zip | 55102-2323
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Country | US
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Telephone | 651-332-3896
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Fax |
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Provider Business Mailing Address
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Address Line | 100 EDGECUMBE DR
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City | MAHTOMEDI
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State | MN
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Zip | 55115-1815
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Country | US
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Telephone | 651-332-3896
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 12607
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License Number State | MN
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Taxonomy #2
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Taxonomy Code | 103TC1900X
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Taxonomy Name | Counseling Psychologist
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License Number | 3882
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License Number State | MN
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