Amundson, Garth William

Amundson, Garth William is an individual health care provider with primary practice located at 1125 6Th St Se , Willmar MN 56201-4675. He recently has only one registered license in Behavioral Health & Social Service Providers / Clinical, which is considered as his primary health care specialty. Amundson, Garth William can be contacted via phone (320) 235-4613.

Contact Information

Primary practice address
1125 6Th St Se Willmar MN 56201-4675
Phone: (320) 235-4613
Fax: (855) 625-7406
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Clinical 103TC0700X 71005077 Illinois
Behavioral Health & Social Service Providers / Clinical 103TC0700X LP6307 Minnesota

Profile Details

NPI number 1629133996
LBN Legal business name Amundson, Garth William
Credentials PSY.D.
Entity Individual
Sole proprietor 1 No
Enumeration date Dec 26th, 2006
Last updated Jun 11th, 2019 - about 6 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1629133996 NPPES
Minnesota Other LP6307 STATE OF MINNESOTA BOARD OF PSYCHOLOGY

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