| Doctor Name: | MARY L. WANDREI |
| NPI Number: | 1124206818 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | PHD |
| License Number: | 4875 |
| Business Practice Address: | 4325 Virginia Ave Shoreview, MN - 551262381 |
| Business Phone Number: | 6517557875 |
| Business Fax Number: | |
| Mailing Address: | 4325 Virginia Ave, SHOREVIEW |
| State: | MN |
| Postal Code: | 551262381 |
| Phone Number: | 6517557875 |
| Fax Number: | |
| NPI Enumeration Date: | 02/05/2008 |
| NPI Last Update Date: | 02/05/2008 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 103TA0700X |
| License Number: | 4875 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | MN |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Psychologist |
| Taxonomy Specialization: | Adult Development & Aging |
| Taxonomy Definition: | |