Individual
MS. KIM MARIE GLEICH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MA, LP
Contact information
Practice address
14949 62ND ST N, STILLWATER, MN 55082-6132
(651) 430-6483
Mailing address
7067 LOWER 94TH ST S, COTTAGE GROVE, MN 55016-3855
(651) 458-0532
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
LP5146
MN
Other
Enumeration date
06/23/2008
Last updated
05/08/2019
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