Doctor Name: | DR. JAMES HARLEN GILBERTSON |
NPI Number: | 1063633469 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | PHD |
License Number: | 1768 |
Business Practice Address: | 2677 Innsbruck Dr Suite D New Brighton, MN - 551126395 |
Business Phone Number: | 6125816655 |
Business Fax Number: | |
Mailing Address: | 3698 Bayview Dr, BARNUM |
State: | MN |
Postal Code: | 557078715 |
Phone Number: | 6125816655 |
Fax Number: | |
NPI Enumeration Date: | 05/01/2007 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 103TC0700X |
License Number: | 1768 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | MN |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Psychologist |
Taxonomy Specialization: | Clinical |
Taxonomy Definition: |