Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103TC2200X | Clinical Child & Adolescent Psychologist | 5408 | MN |
NPI | 1033409537 |
---|---|
Provider Name | Dr. Sarah Nicolette O'shea |
First Address | Golden Valley, MN 55427-3867 |
Second Address | Minneapolis, MN 55415-1623 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 18/04/2011 |
Last Update Date | 11/12/2013 |