Healthcare Provider Details

I. General information

NPI: 1932805637
Provider Name (Legal Business Name): MARNA REED, MA, LP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/03/2023
Last Update Date: 02/03/2023
Certification Date: 02/03/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

570 ASBURY ST STE 106A
SAINT PAUL MN
55104-1852
US

IV. Provider business mailing address

6060 LOGAN AVE S
MINNEAPOLIS MN
55419-2056
US

V. Phone/Fax

Practice location:
  • Phone: 612-670-1330
  • Fax:
Mailing address:
  • Phone: 612-670-1330
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM0850X
TaxonomyAdult Mental Health Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MS. MARNA REED
Title or Position: LICENSED PSYCHOLOGIST
Credential: MA, LP
Phone: 612-670-1330