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Individual

DALE KNUTE LOKKESMOE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
M.A.

Contact information

Practice address
10535 165TH ST W, LAKEVILLE, MN 55044-5729
(952) 435-0022
(952) 435-0095
Mailing address
10535 165TH ST W, LAKEVILLE, MN 55044-5729
(952) 435-0022
(952) 435-0095

Taxonomy

Speciality
Code
Description
License number
State
103TB0200X
Cognitive & Behavioral Psychologist
Primary
LP3587
MN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
414963
BEHAVIORAL HEALTH PROVIDE
MN
01
81G04LA
BLUE CROSS BLUE SHIELD
MN
Enumeration date
11/28/2006
Last updated
07/08/2007
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