Individual
GARY EDWARD DONALDSON
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
MSED
Contact information
Practice address
540 E 1ST ST, WACONIA, MN 55387-1601
(952) 442-4437
(952) 442-3084
Mailing address
540 E 1ST ST, WACONIA, MN 55387-1601
(952) 442-4437
(952) 442-3084
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
LP 1930
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1041966
PREFERRED ONE
MN
01
—
109409
U-CARE
MN
01
—
3015903
BEHAVIORAL HEALTHCARE PRV
MN
01
—
320K7D0
BLUE CROSS BLUE SHIELD
MN
Enumeration date
08/10/2005
Last updated
07/08/2007
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