Individual
DR. DOUGLAS G. FREY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PH.D.
Contact information
Practice address
15798 VENTURE LN, EDEN PRAIRIE, MN 55344-5729
(952) 920-2789
(952) 975-0616
Mailing address
15798 VENTURE LANE, EDEN PRAIRIE, MN 55344-4116
(952) 920-2789
(952) 975-0616
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
LP 2224
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
109306
PREFERRED ONE - BHP
MN
01
—
41B22PS
BLUE CROSS OF MN
MN
Enumeration date
01/31/2007
Last updated
07/08/2007
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