Organization
PSYCHOLOGICAL HEALTHCARE OF MINNESOTA PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DOUGLAS GUTHRIE FREY PH.D. (PRESIDENT)
(952) 920-2789
Entity
Organization
Contact information
Practice address
15798 VENTURE LN, EDEN PRAIRIE, MN 55344-5729
(952) 920-2789
(952) 746-3890
Mailing address
15798 VENTURE LN, EDEN PRAIRIE, MN 55344-5729
(952) 920-2789
(952) 746-3890
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
LP 2224
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
41B22PS
BLUE CROSS BLUE SHIELD
—
05
—
651353100
—
MN
Enumeration date
10/28/2008
Last updated
03/09/2009
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