Individual
DR. VAN MARK GEMMELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PSYD
Contact information
Practice address
563 BIELENBERG DR, SUITE 125, WOODBURY, MN 55125-4425
(651) 829-6610
(651) 739-1998
Mailing address
563 BIELENBERG DR, SUITE 125, WOODBURY, MN 55125-4425
(651) 829-6610
(651) 739-1998
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
LP5177
MN
Other
Enumeration date
12/08/2009
Last updated
09/24/2014
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