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NPI Code Detail

MEDICARE: MICHAELA FREER

MEDICARE: MICHAELA FREER
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1106S00000XBehavior Technician

General Provider Information

NPI Number : 1174250393
Entity Type Code : Individual
Provider Name (Legal Business Name) : MICHAELA FREER
Provider Business Mailing Address
First Line : 37692 EVERGREEN AVE
Second Line :
City : NORTH BRANCH
State : MN
Zip : 55056-5539
Country : US
Telephone Number : 651-900-0655
Fax Number :
Provider Business Practice Location Address
First Line : 3401 ROUND LAKE BLVD NW
Second Line :
City : ANOKA
State : MN
Zip : 55303-3315
Country : US
Telephone Number : 612-509-7113
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/07/2022
Last Update Date : 08/07/2022

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Directions to “ MICHAELA FREER ” Practice Location

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