Individual
SUSAN DE VRIES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MA, LP
Contact information
Practice address
570 ASBURY ST, SUITE 310, SAINT PAUL, MN 55104-1849
(651) 646-7010
(651) 646-7668
Mailing address
570 ASBURY ST, SUITE 310, SAINT PAUL, MN 55104-1849
(651) 646-7010
(651) 646-7668
Taxonomy
Speciality
Code
Description
License number
State
103TF0000X
Family Psychologist
Primary
LP 1035
MN
Other
Enumeration date
03/12/2009
Last updated
03/12/2009
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