Individual
DR. GILLIAN AMANDA GERVAIS FREEBORN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PSYD
Contact information
Practice address
2102 ELM STREET N, FARGO, ND 58102-2498
(701) 239-3700
Mailing address
2101 ELM ST N, FARGO, ND 58102-2417
(701) 526-6870
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
506
ND
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
07/16/2013
Last updated
04/15/2021
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