Gustafson, Donae Verbena
Gustafson, Donae Verbena is an sole proprietor health care provider with primary practice located at 6120 Oren Ave N , Stillwater MN 55082-6155. She recently has only one registered license in Behavioral Health & Social Service Providers / Clinical, which is considered as her primary health care specialty. Gustafson, Donae Verbena can be contacted via phone (651) 430-0888.Contact Information
Primary practice address
6120 Oren Ave N
Stillwater MN 55082-6155
Phone: (651) 430-0888
Fax: (651) 430-0889
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Clinical | 103TC0700X | LP 3566 | Minnesota |
Profile Details
| NPI number | 1598820367 |
|---|---|
| LBN Legal business name | Gustafson, Donae Verbena |
| Credentials | PSY. D. |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Dec 22nd, 2006 |
| Last updated | May 12th, 2010 - about 15 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1598820367 | NPPES |
| Minnesota | Other | 000-562-8542 | AETNA |
| Minnesota | Other | 11-5651 | AETNA |
| Minnesota | MEDICAID | 76-83570-00 | AETNA |
| Minnesota | Other | 61-62456 | AETNA |
| Minnesota | Other | 58G12GU | AETNA |
| Minnesota | Other | 76-83570-00 | AETNA |
| Minnesota | Other | HP16320 | AETNA |
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