Provider Demographics
NPI:1194875294
Name:FREIER, MARY-MARGARET ELLEN (PSY D)
Entity type:Individual
Prefix:DR
First Name:MARY-MARGARET
Middle Name:ELLEN
Last Name:FREIER
Suffix:
Gender:F
Credentials:PSY D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2842 MAIN ST
Mailing Address - Street 2:PMB 128
Mailing Address - City:GLASTONBURY
Mailing Address - State:CT
Mailing Address - Zip Code:06033-1077
Mailing Address - Country:US
Mailing Address - Phone:860-281-4318
Mailing Address - Fax:860-537-1033
Practice Address - Street 1:4 VAN CEDARFIELD RD.
Practice Address - Street 2:
Practice Address - City:COLCHESTER
Practice Address - State:CT
Practice Address - Zip Code:06415
Practice Address - Country:US
Practice Address - Phone:860-281-4318
Practice Address - Fax:860-537-1033
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-11
Last Update Date:2009-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT002963103TA0400X, 103TB0200X, 103TC0700X, 103TC1900X, 103TC2200X, 103TP2701X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
No103TA0400XBehavioral Health & Social Service ProvidersPsychologistAddiction (Substance Use Disorder)
No103TB0200XBehavioral Health & Social Service ProvidersPsychologistCognitive & Behavioral
No103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounseling
No103TC2200XBehavioral Health & Social Service ProvidersPsychologistClinical Child & Adolescent
No103TP2701XBehavioral Health & Social Service ProvidersPsychologistGroup Psychotherapy