Provider Demographics
NPI:1932473105
Name:SATHER, MICHELLE LEE (LADC)
Entity Type:Individual
Prefix:MRS
First Name:MICHELLE
Middle Name:LEE
Last Name:SATHER
Suffix:
Gender:F
Credentials:LADC
Other - Prefix:
Other - First Name:MICHELLE
Other - Middle Name:LEE
Other - Last Name:SCHMOLL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LADC
Mailing Address - Street 1:343 WOODLAKE DRIVE SE
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER
Mailing Address - State:MN
Mailing Address - Zip Code:55904
Mailing Address - Country:US
Mailing Address - Phone:507-289-2089
Mailing Address - Fax:507-535-5789
Practice Address - Street 1:343 WOODLAKE DRIVE SE
Practice Address - Street 2:
Practice Address - City:ROCHESTER
Practice Address - State:MN
Practice Address - Zip Code:55904
Practice Address - Country:US
Practice Address - Phone:507-289-2089
Practice Address - Fax:507-535-5989
Is Sole Proprietor?:No
Enumeration Date:2012-03-05
Last Update Date:2015-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN303300101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)