Doctor Name: | DR. HARLAN JAMES GILBERTSON |
NPI Number: | 1043388002 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | LP |
License Number: | MN LP2591 |
Business Practice Address: | 630 Union St S Mora, MN - 550511818 |
Business Phone Number: | 3206798161 |
Business Fax Number: | 3206795258 |
Mailing Address: | 630 Union St S, MORA |
State: | MN |
Postal Code: | 550511818 |
Phone Number: | 3206798161 |
Fax Number: | 3206795258 |
NPI Enumeration Date: | 11/30/2006 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 103TC0700X |
License Number: | MN LP2591 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | MN |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Psychologist |
Taxonomy Specialization: | Clinical |
Taxonomy Definition: |