Provider Demographics
NPI:1952052193
Name:DIRNBERGER, SOPHIE ELIZABETH
Entity Type:Individual
Prefix:
First Name:SOPHIE
Middle Name:ELIZABETH
Last Name:DIRNBERGER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:322 7TH AVE N
Mailing Address - Street 2:
Mailing Address - City:HOPKINS
Mailing Address - State:MN
Mailing Address - Zip Code:55343-7373
Mailing Address - Country:US
Mailing Address - Phone:612-916-4028
Mailing Address - Fax:
Practice Address - Street 1:1801 AMERICAN BLVD E
Practice Address - Street 2:
Practice Address - City:BLOOMINGTON
Practice Address - State:MN
Practice Address - Zip Code:55425-1232
Practice Address - Country:US
Practice Address - Phone:952-767-2267
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-01-10
Last Update Date:2022-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician