Individual
MR. GERARD DAVID LASALLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MS LP
Contact information
Practice address
17305 CEDAR AVE SOUTH, SUITE 230, LAKEVILLE, MN 55044
(952) 435-4144
(952) 435-4149
Mailing address
7486 157TH ST W, #103, APPLE VALLEY, MN 55124
(507) 581-1800
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
LP1359
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
11047315
PREFERRED ONE
MN
01
—
826T5LA
BCBS
MN
Enumeration date
12/04/2006
Last updated
07/08/2007
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