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NPI Code Detail

MEDICARE: FREY-HAWKINS PSYCHOLOGICAL SERVICES, PLLC

MEDICARE: FREY-HAWKINS PSYCHOLOGICAL SERVICES, PLLC
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
1251S00000XCommunity/Behavioral Health AgencyLP0414MN

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1649564766
Entity Type Code : Organization
Provider Name (Legal Business Name) : FREY-HAWKINS PSYCHOLOGICAL SERVICES, PLLC
Provider Business Mailing Address
First Line : 1304 MARSHALL ST
Second Line : SUITE 2
City : SAINT PETER
State : MN
Zip : 56082-4500
Country : US
Telephone Number : 507-934-2232
Fax Number : 507-934-2096
Provider Business Practice Location Address
First Line : 1304 MARSHALL ST
Second Line : SUITE 2
City : SAINT PETER
State : MN
Zip : 56082-4500
Country : US
Telephone Number : 507-934-2232
Fax Number : 507-934-2096
Authorized Official
Title or Position : CHIEF MANAGER
Name : MS. JOANN PATRICE FREY-HAWKINS
Credential : M.A., L.P.
Telephone Number : 507-934-2232
Provider Enumeration Date : 06/06/2011
Last Update Date : 06/06/2011

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