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Individual

MS. BRIDGET LEE LYNN GUTKNECHT

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
14387 EDGEWOOD DR, BAXTER, MN 56425-8460
(218) 454-5181
Mailing address
218 DAKOTA AVE SW, STAPLES, MN 56479-2638
(218) 402-0513

Taxonomy

Speciality
Code
Description
License number
State
106E00000X
Assistant Behavior Analyst
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
9204
NON
Enumeration date
05/10/2022
Last updated
05/10/2022
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