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General NPI Number Information
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NPI Number | 1699981829
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Entity Type | Organization
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Legal Business Name | SHERYL NIEBUHR CONSULTING, LLC
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Dates
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Enumeration Date | 05/15/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 2233 HAMLINE AVE N SUITE 525
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City | ROSEVILLE
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State | MN
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Zip | 55113-5009
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Country | US
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Telephone | 651-439-8744
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Fax |
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Provider Business Mailing Address
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Address Line | 5865 NEAL AVE N #203
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City | STILLWATER
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State | MN
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Zip | 55082-2177
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Country | US
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Telephone | 651-439-8744
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Fax |
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Authorized Official
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Title or Position | MANAGING MEMBER
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Name | DR. SHERYL L. NIEBUHR
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Credential | PH.D., L.P.
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Telephone | 651-439-8744
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103T00000X
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Taxonomy Name | Psychologist
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License Number | LP1365
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License Number State | MN
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