RENEE FREDRICKSON


Address: 1248 Bucher Ave, Saint Paul, MN 55126-8602
Phone: 6516468373

RENEE FREDRICKSON (NPI# 1306171889) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1306171889
Entity Type Individual
Full Name RENEE FREDRICKSON
Credential PHD, L.P.
Practice Address 1248 Bucher Ave
Saint Paul
MN 55126-8602
Practice Telephone 6516468373
Mailing Telephone 6516468373
Enumeration Date 2009-10-16
Last Update Date 2009-11-20
Gender Code F
Is Sole Proprietor Y

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 103TC1900X Psychologist
Specialization: Counseling
LP2653 MN Behavioral Health & Social Service Providers

Office Location

Street Address 1248 BUCHER AVE
City SAINT PAUL
State MN
Zip Code 55126-8602

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Taxonomy Information

Taxonomy Code 103TC1900X
Grouping Behavioral Health & Social Service Providers
Classification Psychologist
Specialization Counseling

Taxonomy Definition

Definition to come...

Providers in the same taxonomy and city

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1124597133 Take Flight Counseling Services LLC Psychologist 1821 University Ave W Ste S303, Saint Paul, MN 55104-2813 2018-11-19
1679020226 Internal Revolution Counseling and Consulting, L.L.C. Psychologist 1123 Grand Avenue, Suite 201, Saint Paul, MN 55105 2016-09-01
1851845267 Sharon Black Psychologist 1774 Sheridan Ave, Saint Paul, MN 55116-2730 2016-08-15
1457760316 Mera Kachgal Psychologist 121 7th Pl E Ste 300, Dds, Saint Paul, MN 55101-2116 2014-08-05
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1780992479 Michael V. Desanctis, Phd, Abpp, Licensed Psychologist Pllc Psychologist 413 Wacouta St Ste 550, Saint Paul, MN 55101-1645 2010-09-16
1689826158 Sheila Maland Psychologist 311 Ramsey St Ste 205, Saint Paul, MN 55102-2323 2008-10-16
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Competitor

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City SAINT PAUL
Zip Code 55126

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.

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