Provider Demographics
NPI:1427296961
Name:DWYER, SHEILA GERETTE (LMFT)
Entity type:Individual
Prefix:
First Name:SHEILA
Middle Name:GERETTE
Last Name:DWYER
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3616 BAILEY RIDGE CIR
Mailing Address - Street 2:
Mailing Address - City:WOODBURY
Mailing Address - State:MN
Mailing Address - Zip Code:55125-8467
Mailing Address - Country:US
Mailing Address - Phone:651-270-9591
Mailing Address - Fax:
Practice Address - Street 1:3616 BAILEY RIDGE CIR
Practice Address - Street 2:
Practice Address - City:WOODBURY
Practice Address - State:MN
Practice Address - Zip Code:55125-8467
Practice Address - Country:US
Practice Address - Phone:651-270-9591
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-01-21
Last Update Date:2022-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN1693106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist