Individual
RENEE FREDRICKSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PHD, L.P.
Contact information
Practice address
1248 BUCHER AVE, SAINT PAUL, MN 55126-8602
(651) 646-8373
Mailing address
1248 BUCHER AVE, SAINT PAUL, MN 55126-8602
(651) 646-8373
Taxonomy
Speciality
Code
Description
License number
State
103TC1900X
Counseling Psychologist
Primary
LP2653
MN
Other
Enumeration date
10/16/2009
Last updated
11/20/2009
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