Mary L. Wandrei
Family Psychologist Clinical Psychologist Adult Development & Aging Psychologist Clinical Child & Adolescent Psychologist
4325 Virginia Ave
Shoreview
, Minnesota 55126-2381
Mary L. Wandrei
Family Psychologist Clinical Psychologist Adult Development & Aging Psychologist Clinical Child & Adolescent Psychologist
4325 Virginia Ave
Shoreview
, Minnesota 55126-2381
(651) 755-7875
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About
Features
Specialties
- Adult Development & Aging Psychologist
- Clinical Psychologist
- Clinical Child & Adolescent Psychologist
- Family Psychologist
Languages spoken
- English
Location
First Address
- Mary L. Wandrei
- 4325 Virginia Ave
- Shoreview, MN
- Zip : 55126-2381
- Phone : (651) 755-7875
Second Address
- Mary L. Wandrei
- 4325 Virginia Ave
- Shoreview, MN
- Zip : 55126-2381
- Phone : (651) 755-7875
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| N | 103TA0700X | Adult Development & Aging Psychologist | 4875 | MN |
| Y | 103G00000X | Clinical Psychologist | 4875 | MN |
| Y | 103TC0700X | Clinical Psychologist | 4875 | MN |
| N | 103TC2200X | Clinical Child & Adolescent Psychologist | 4875 | MN |
| N | 103TF0000X | Family Psychologist | 4875 | MN |
National Provider Identifier
| NPI | 1124206818 |
|---|---|
| Provider Name | Mary L. Wandrei |
| First Address | Shoreview, MN 55126-2381 |
| Second Address | Shoreview, MN 55126-2381 |
| Gender | F |
| NPI Entity type | Individual |
| Is Sole Proprietor | Yes |
| Is Organization Subpart | N/A |
| Enumeration Date | 05/02/2008 |
| Last Update Date | 05/02/2008 |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.