Healthcare Provider Details

I. General information

NPI: 1104537497
Provider Name (Legal Business Name): PSALMS T FRYE CD(DONA), MBA, MATS,
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/08/2022
Last Update Date: 12/08/2022
Certification Date: 12/08/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5247 FLORENCE DR NW
ROCHESTER MN
55901-4860
US

IV. Provider business mailing address

5247 FLORENCE DR NW
ROCHESTER MN
55901-4860
US

V. Phone/Fax

Practice location:
  • Phone: 507-990-8521
  • Fax:
Mailing address:
  • Phone: 150-799-0852
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code374J00000X
TaxonomyDoula
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: