Sharon R Koukkari LLC
Organization Active NPI Community/Behavioral Health Agency · St Louis PK, MN
NPI 1306170741 · NPPES record last updated Oct 1, 2009
Key facts
- NPI
- 1306170741
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Community/Behavioral Health Agency 251S00000X
- License
- LP1444 (MN)
- Legal business name
- SHARON R KOUKKARI LLC
- Practice address
- 5354 Parkdale Dr
Suite 300
St Louis PK, MN 55416-1603 - Phone
- (512) 889-1692
- Fax
- (952) 546-1445
- NPI assigned
- Oct 1, 2009
- Organization subpart
- No
Authorized official
- Name
- Sharon R Koukkari, M.S., L.P.
- Title
- President
- Phone
- (612) 889-1692
Practitioners 1
-
Sharon R Koukkari, M.S., L.P.
National Provider Directory
Locations
5354 Parkdale Dr
Ste 300
St Louis Park, MN 55416
Phone (612) 532-2723
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Community/Behavioral Health Agency | 251S00000X | LP1444 | MN | Yes |
Addresses
Primary practice location
5354 Parkdale Dr
Suite 300
St Louis PK, MN 55416-1603
Mailing address
19320 81St PL N
Maple Grove, MN 55311-1625
Phone (612) 889-1692
Other providers in St Louis PK, MN
All providers in St Louis PK, MN · Community/Behavioral Health Agency in Minnesota
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 1, 2009. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.