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Individual
GARY PAULSON
Active
Individual
GARY PAULSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LADC
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
300891
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1032488
P1
MN
01
—
111576
UC
MN
01
—
33239
HP
MN
01
—
57422KU
BCBS
MN
01
—
84-61062
UBH
MN
Enumeration date
07/27/2006
Last updated
07/08/2007
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