Provider Demographics
NPI:1104975705
Name:KANTERS, SHARON E (MA)
Entity type:Individual
Prefix:MS
First Name:SHARON
Middle Name:E
Last Name:KANTERS
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:9311 XYLON CIR S
Mailing Address - Street 2:
Mailing Address - City:BLOOMINGTON
Mailing Address - State:MN
Mailing Address - Zip Code:55438-1443
Mailing Address - Country:US
Mailing Address - Phone:952-944-1876
Mailing Address - Fax:953-942-5726
Practice Address - Street 1:8897 AZTEC DR
Practice Address - Street 2:
Practice Address - City:EDEN PRAIRIE
Practice Address - State:MN
Practice Address - Zip Code:55347-1901
Practice Address - Country:US
Practice Address - Phone:952-944-1876
Practice Address - Fax:952-942-5726
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-10
Last Update Date:2009-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MNLP3088103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist