Provider Demographics
NPI:1871505248
Name:LEATRICE MANKIN SHERER, PH.D., P.L.L.C.
Entity Type:Organization
Organization Name:LEATRICE MANKIN SHERER, PH.D., P.L.L.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:LEATRICE
Authorized Official - Middle Name:MANKIN
Authorized Official - Last Name:SHERER
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:612-579-0808
Mailing Address - Street 1:1163 LAUREL AVE
Mailing Address - Street 2:
Mailing Address - City:SAINT PAUL
Mailing Address - State:MN
Mailing Address - Zip Code:55104-6926
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:413 WACOUTA ST
Practice Address - Street 2:SUITE 550, THE GILBERT BUILDING
Practice Address - City:SAINT PAUL
Practice Address - State:MN
Practice Address - Zip Code:55101-1644
Practice Address - Country:US
Practice Address - Phone:612-579-0808
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-13
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Single Specialty