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NPI Code Detail

MEDICARE: SHANNON MARIE KEHLE-FORBES PH.D., L.P.

MEDICARE: SHANNON MARIE KEHLE-FORBES PH.D., L.P.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1103TC0700XClinical PsychologistLP5123MN

General Provider Information

NPI Number : 1003000894
Entity Type Code : Individual
Provider Name (Legal Business Name) : SHANNON MARIE KEHLE-FORBES PH.D., L.P.
Provider Business Mailing Address
First Line : 7201 METRO BLVD STE 550
Second Line :
City : EDINA
State : MN
Zip : 55439-1353
Country : US
Telephone Number : 612-361-4588
Fax Number :
Provider Business Practice Location Address
First Line : 7201 METRO BLVD STE 550
Second Line :
City : EDINA
State : MN
Zip : 55439-1353
Country : US
Telephone Number : 612-361-4588
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/05/2007
Last Update Date : 03/24/2025

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