Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 101YP2500X | Professional Counselor | 00399 | MN |
Y | 103TC1900X | Counseling Psychologist | LP5261 | MN |
NPI | 1023170958 |
---|---|
Provider Name | Mrs. Sarah Fuerst |
First Address | Maplewood, MN 55109-4928 |
Second Address | Woodbury, MN 55125-4919 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 15/12/2006 |
Last Update Date | 12/12/2010 |