Provider Demographics
NPI:1386372084
Name:DELAMBO, SHERI LEE (MA)
Entity type:Individual
Prefix:MS
First Name:SHERI
Middle Name:LEE
Last Name:DELAMBO
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1012 4TH ST SE
Mailing Address - Street 2:
Mailing Address - City:FOREST LAKE
Mailing Address - State:MN
Mailing Address - Zip Code:55025-2088
Mailing Address - Country:US
Mailing Address - Phone:651-815-5018
Mailing Address - Fax:651-982-6035
Practice Address - Street 1:1068 LAKE ST S STE 109
Practice Address - Street 2:
Practice Address - City:FOREST LAKE
Practice Address - State:MN
Practice Address - Zip Code:55025-2633
Practice Address - Country:US
Practice Address - Phone:651-982-4792
Practice Address - Fax:651-982-6035
Is Sole Proprietor?:No
Enumeration Date:2022-08-10
Last Update Date:2024-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN306225101YA0400X
390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)