Vikesland, Gary D

Vikesland, Gary D is an individual health care provider with primary practice located at 10700 Old County Road 15 Ste 170 , Plymouth MN 55441-8709. He recently has only one registered license in Behavioral Health & Social Service Providers / Counseling, which is considered as his primary health care specialty. Vikesland, Gary D can be contacted via phone (763) 525-8590.

Contact Information

Primary practice address
10700 Old County Road 15 Ste 170 Plymouth MN 55441-8709
Phone: (763) 525-8590
Fax: (763) 525-8592
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Counseling 103TC1900X LP3160 Minnesota

Profile Details

NPI number 1073506846
LBN Legal business name Vikesland, Gary D
Credentials PHD
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 26th, 2005
Last updated Jan 17th, 2024 - about last year

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 1073506846 NPPES
Minnesota MEDICAID 069523800

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