Provider Demographics
NPI:1811480262
Name:KREUTER, SARAH MARIE (BCABA, BS)
Entity type:Individual
Prefix:MRS
First Name:SARAH
Middle Name:MARIE
Last Name:KREUTER
Suffix:
Gender:F
Credentials:BCABA, BS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8720 30TH ST NE
Mailing Address - Street 2:
Mailing Address - City:SAINT MICHAEL
Mailing Address - State:MN
Mailing Address - Zip Code:55376-9237
Mailing Address - Country:US
Mailing Address - Phone:612-670-6175
Mailing Address - Fax:
Practice Address - Street 1:2419 WASHINGTON AVE
Practice Address - Street 2:
Practice Address - City:MONTEVIDEO
Practice Address - State:MN
Practice Address - Zip Code:56265-2619
Practice Address - Country:US
Practice Address - Phone:320-894-8476
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-06-11
Last Update Date:2023-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN0-11-4284103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst