Individual
DR. TIMOTHY TRELL EATON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PHD
Contact information
Practice address
1705 4TH AVE NW, MINOT, ND 58703-2912
(701) 839-0474
(701) 839-0713
Mailing address
1705 4TH AVE NW, MINOT, ND 58703-2912
(701) 839-0474
(701) 839-0713
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
190
ND
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
16943
—
ND
01
—
5297
BLUE CROSS BLUE SHIELD
ND
01
—
90688
SS DISABILITY DETERMINATI
ND
Enumeration date
09/16/2006
Last updated
07/08/2007
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