Healthcare Provider Details

I. General information

NPI: 1891963781
Provider Name (Legal Business Name): FREY PSYCHOLOGY CENTER LTD
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/14/2008
Last Update Date: 02/14/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

723 E COURT ST
PARIS IL
61944
US

IV. Provider business mailing address

723 E COURT ST
PARIS IL
61944
US

V. Phone/Fax

Practice location:
  • Phone: 217-463-2002
  • Fax: 217-463-7202
Mailing address:
  • Phone: 217-463-2002
  • Fax: 217-463-7202

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number
License Number StateIL

VIII. Authorized Official

Name: DR. MARILYN FREY
Title or Position: PRESIDENT
Credential: PHD
Phone: 217-463-2002