Provider Demographics
NPI:1497195358
Name:FLAGET-GREENER, MARGARET ANNE (PSYD)
Entity Type:Individual
Prefix:DR
First Name:MARGARET
Middle Name:ANNE
Last Name:FLAGET-GREENER
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:630 MARSHALL AVE
Mailing Address - Street 2:APT. #1
Mailing Address - City:SAINT PAUL
Mailing Address - State:MN
Mailing Address - Zip Code:55104-7205
Mailing Address - Country:US
Mailing Address - Phone:610-675-4249
Mailing Address - Fax:
Practice Address - Street 1:3100 W LAKE ST
Practice Address - Street 2:SUITE 21
Practice Address - City:MINNEAPOLIS
Practice Address - State:MN
Practice Address - Zip Code:55416-4527
Practice Address - Country:US
Practice Address - Phone:610-675-4249
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-06-25
Last Update Date:2013-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MNLP5625103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical