Provider Demographics
NPI:1568118065
Name:SHER, CALLEEN (MS)
Entity Type:Individual
Prefix:
First Name:CALLEEN
Middle Name:
Last Name:SHER
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:21370 JOHN MILLESS DR STE 106
Mailing Address - Street 2:
Mailing Address - City:ROGERS
Mailing Address - State:MN
Mailing Address - Zip Code:55374-4622
Mailing Address - Country:US
Mailing Address - Phone:763-232-5879
Mailing Address - Fax:
Practice Address - Street 1:21370 JOHN MILLESS DR STE 106
Practice Address - Street 2:
Practice Address - City:ROGERS
Practice Address - State:MN
Practice Address - Zip Code:55374-4622
Practice Address - Country:US
Practice Address - Phone:763-232-5879
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-02-23
Last Update Date:2022-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist