Individual
GEOFFREY CLYDE AMMERMAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MS.ED., LP
Contact information
Practice address
927 TRETTEL LN, CLOQUET, MN 55720-1345
(218) 879-1227
Mailing address
927 TRETTEL LN, CLOQUET, MN 55720-1345
(218) 879-1227
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
LP1904
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
870748100
—
MN
Enumeration date
07/07/2006
Last updated
04/18/2017
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