Individual
MICHELLE K. PEMBLE-FRAZEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHD
Contact information
Practice address
9555 UPLAND LN N, MAPLE GROVE, MN 55369
(952) 993-1440
Mailing address
8170 33RD AVE S # MS 21110Q, BLOOMINGTON, MN 55425-4516
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
LP4824
MN
103TB0200X
Cognitive & Behavioral Psychologist
Primary
LP4824
MN
Other
Enumeration date
07/17/2007
Last updated
09/13/2023
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