Individual
SHARON R FRIES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.A., L.M.F.T.
Contact information
Practice address
2233 HAMLINE AVE N, SUITE 609, ROSEVILLE, MN 55113-5009
(651) 230-0492
Mailing address
1068 LAKE ST S, SUITE 109, FOREST LAKE, MN 55025-2639
(651) 230-0492
(651) 982-6035
Taxonomy
Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
Primary
0938
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1601130-00
—
MN
01
—
275K4LI
BLUE CROSS BLUE SHIELD
MN
Enumeration date
12/04/2006
Last updated
10/24/2012
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