Individual
MARY L. WANDREI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PHD
Contact information
Practice address
4325 VIRGINIA AVE, SHOREVIEW, MN 55126-2381
(651) 755-7875
Mailing address
4325 VIRGINIA AVE, SHOREVIEW, MN 55126-2381
(651) 755-7875
Taxonomy
Speciality
Code
Description
License number
State
103TA0700X
Adult Development & Aging Psychologist
4875
MN
103TC0700X
Clinical Psychologist
Primary
4875
MN
103TC2200X
Clinical Child & Adolescent Psychologist
4875
MN
103TF0000X
Family Psychologist
4875
MN
Other
Enumeration date
02/05/2008
Last updated
02/05/2008
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