Provider Demographics
NPI:1104347210
Name:CZIPRI, SHEENA LEE (PSYD)
Entity type:Individual
Prefix:
First Name:SHEENA
Middle Name:LEE
Last Name:CZIPRI
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:316 N EXCELDA AVE
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33609-1620
Mailing Address - Country:US
Mailing Address - Phone:630-846-1020
Mailing Address - Fax:
Practice Address - Street 1:1 VETERANS DR.
Practice Address - Street 2:MINNEAPOLIS VA HEALTH CARE SYSTEM
Practice Address - City:MINNEAPOLIS
Practice Address - State:MN
Practice Address - Zip Code:55417
Practice Address - Country:US
Practice Address - Phone:612-725-2000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-06-28
Last Update Date:2017-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPY9661103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical