Individual
KATIE REGER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PH.D.
Contact information
Practice address
225 SMITH AVE N, SUITE 201, SAINT PAUL, MN 55102-2533
(651) 241-5119
Mailing address
3300 FERNBROOK LN N STE 120, PLYMOUTH, MN 55447-5339
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
LP5922
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
CO1523
—
MN
Enumeration date
04/26/2016
Last updated
09/03/2019
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