| Doctor Name: | ADAM LEE GATZKE |
| NPI Number: | 1053670059 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | |
| License Number: | |
| Business Practice Address: | 8441 Wayzata Blvd Ste 160 Golden Valley, MN - 554261367 |
| Business Phone Number: | 7635660088 |
| Business Fax Number: | 7635660089 |
| Mailing Address: | 200 Nathan Ln N Apt 351, PLYMOUTH |
| State: | MN |
| Postal Code: | 554416490 |
| Phone Number: | 9524125909 |
| Fax Number: | |
| NPI Enumeration Date: | 05/10/2012 |
| NPI Last Update Date: | 05/10/2012 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YM0800X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Mental Health |
| Taxonomy Definition: | |