Individual
CHARLES FIELDS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MA, LP
Contact information
Practice address
13021 EVERGREEN DR, BAXTER, MN 56425-7439
(218) 829-9307
Mailing address
1900 SILVER LAKE RD NW, SUITE 110, NEW BRIGHTON, MN 55112-1786
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
0231
MN
Other
Enumeration date
02/06/2009
Last updated
02/06/2009
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