Organization
MODERN MIND WELLNESS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TREVOR D FRYBARGER LICSW (MANAGER/LICENSED THERAPIST)
(507) 218-8394
Entity
Organization
Contact information
Practice address
25691 S. FAIRBURN RD, FAIRBURN, SD 57738
(507) 218-8394
Mailing address
PO BOX 94, FAIRBURN, SD 57738-0094
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
—
—
Other
Enumeration date
12/21/2023
Last updated
01/22/2024
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