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Organization

INTEGRATIVE PSYCHOLOGICAL SERVICES, P.A.

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. MARY GENEVIEVE FREITAG PSY.D., L.P. (LICENSED CLINICAL PSYCHOLOGIST)
(651) 357-3216
Entity
Organization

Contact information

Practice address
10480 PERKINS AVE N, STILLWATER, MN 55082-9273
(651) 357-3216
(651) 430-8085
Mailing address
10480 PERKINS AVE N, STILLWATER, MN 55082-9273
(651) 357-3216
(651) 430-8085

Taxonomy

Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
LP4319
MN
261QM0850X
Adult Mental Health Clinic/Center

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
028H0HA
MENTAL HEALTH
MN
05
0492456
MN
01
1028022
MENTAL HEALTH
MN
01
103T00000X
PSYCHOLOGIST
MN
01
130952
MENTAL HEALTH
MN
01
1382591
MENTAL HEALTH
MN
01
61-57516
MENTAL HEALTH
MN
01
74G37FR
MENTAL HEALTH
MN
01
HP33776
MENTAL HEALTH
MN
Enumeration date
06/18/2007
Last updated
11/01/2023
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