Individual
DR. MARYANNE REILLY-SPONG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PHD
Contact information
Practice address
420 DELAWARE ST SE, STE 1460-7 MAYO, MINNEAPOLIS, MN 55455
(612) 750-1771
Mailing address
420 DELAWARE ST SE, STE 1460-7 MAYO, MMC 293, MINNEAPOLIS, MN 55455
(612) 625-9946
Taxonomy
Speciality
Code
Description
License number
State
103TC1900X
Counseling Psychologist
Primary
LP6630
MN
Other
Enumeration date
10/10/2023
Last updated
10/10/2023
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