Individual
PAUL J GOOSSENS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MA,LP
Contact information
Practice address
314 W SUPERIOR ST, 702, DULUTH, MN 55802-1805
(218) 722-4058
(218) 722-5059
Mailing address
314 W SUPERIOR ST, 702, DULUTH, MN 55802-1805
(218) 722-4058
(218) 722-5059
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
LP2592
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1006856
BHP
MN
01
—
110228
U-CARE
MN
01
—
385R7HA
BLUE CROSSBLUE SHIELD
MN
01
—
466646
VALUE OPTIONS
MN
01
—
6240177
MEDICA
MN
Enumeration date
03/20/2007
Last updated
07/08/2007
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