Doctor Name: | SHARON L BORTSCHELLER |
NPI Number: | 1013083039 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | LICSW |
License Number: | 11859 |
Business Practice Address: | 101 Lexington Ave South New Prague, MN - 56071 |
Business Phone Number: | 9522126069 |
Business Fax Number: | 9529600821 |
Mailing Address: | 13217 Birchwood Lane, BURNSVILLE |
State: | MN |
Postal Code: | 55337 |
Phone Number: | 9522126069 |
Fax Number: | 9529600821 |
NPI Enumeration Date: | 11/28/2006 |
NPI Last Update Date: | 10/29/2008 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 1041C0700X |
License Number: | 11859 |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | MN |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Social Worker |
Taxonomy Specialization: | Clinical |
Taxonomy Definition: | A social worker who holds a master |