Individual
DR. J. GABRIEL MYDLAND
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
EDD LPC
Contact information
Practice address
928 4TH ST, SUITE 6, BROOKINGS, SD 57006-2171
(605) 691-0463
Mailing address
120 22ND AVE S PMB 179, BROOKINGS, SD 57006
(605) 691-0463
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
1057
SD
Other
Enumeration date
05/18/2007
Last updated
07/08/2007
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