MEDICARE: DR. SANDRA LEA NOHRE PHD

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
1	103T00000X	Psychologist	2886	MN
2	106H00000X	Marriage & Family Therapist	483	MN

General Provider Information

NPI Number	:	1790840346
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. SANDRA LEA NOHRE PHD

Provider Business Mailing Address
First Line	:	5871 CEDAR LAKE ROAD
Second Line	:	100 SUNSET RIDGE BUSINESS PARK
City	:	MINNEAPOLIS
State	:	MN
Zip	:	55416-1481
Country	:	US
Telephone Number	:	952-944-1585
Fax Number	:	952-918-0328

Provider Business Practice Location Address
First Line	:	5871 CEDAR LAKE ROAD
Second Line	:	100 SUNSET RIDGE BUSINESS PARK
City	:	MINNEAPOLIS
State	:	MN
Zip	:	55416-1481
Country	:	US
Telephone Number	:	952-944-1585
Fax Number	:	952-918-0328

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/26/2006
Last Update Date	:	09/11/2025

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