Individual
WALTER O BOCKTING
Active
Individual
WALTER O BOCKTING
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHD
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
LP2505
MN
103TC0700X
Clinical Psychologist
Primary
020658
NY
103TC0700X
Clinical Psychologist
LP2505
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
048313300
—
MN
01
—
1007664
PREFERREDONE
MN
01
—
102450
UCARE
MN
01
—
602T9BO
BLUE CROSS BLUE SHIELD
MN
01
—
61-81256
MEDICA - CHOICE
MN
01
—
HP50070
HEALTHPARTNERS
MN
Enumeration date
10/26/2006
Last updated
03/19/2024
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