| NPI | 1548465883 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARY GENEVIEVE FREITAG Licensed Clinical Psychologist 651-357-3216 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103T00000X Psychologist (Licence: MN LP4319) |
| Additional Taxonomies | 261QM0850X Clinic/Center, Adult Mental Health |
| Enumeration Date | 2007-06-18 |
| Last Update Date | 2023-11-01 |