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Individual

FABIO ANDRE AZEREDO

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man

Contact information

Practice address
250 CARLSON PKWY APT 202, MINNETONKA, MN 55305-5320
(612) 704-3339
Mailing address
250 CARLSON PKWY APT 202, MINNETONKA, MN 55305-5320
(612) 704-3339

Taxonomy

Speciality
Code
Description
License number
State
103TP0814X
Psychoanalysis Psychologist
Primary

Other

Enumeration date
02/21/2022
Last updated
02/21/2022
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