Provider Demographics
NPI:1720576788
Name:FREYBERGER, RACHEL MARIE (LP)
Entity Type:Individual
Prefix:DR
First Name:RACHEL
Middle Name:MARIE
Last Name:FREYBERGER
Suffix:
Gender:F
Credentials:LP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:409 DUNLAP ST N
Mailing Address - Street 2:
Mailing Address - City:SAINT PAUL
Mailing Address - State:MN
Mailing Address - Zip Code:55104-4201
Mailing Address - Country:US
Mailing Address - Phone:651-251-5920
Mailing Address - Fax:651-251-5995
Practice Address - Street 1:409 DUNLAP ST N
Practice Address - Street 2:
Practice Address - City:SAINT PAUL
Practice Address - State:MN
Practice Address - Zip Code:55104-4201
Practice Address - Country:US
Practice Address - Phone:651-251-5920
Practice Address - Fax:651-251-5995
Is Sole Proprietor?:No
Enumeration Date:2018-04-25
Last Update Date:2023-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MNLP6698103TC1900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounseling
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN225869Medicaid