Individual
DR. GAIL ANN NOLLER
Active
Sole proprietor
Provider details
NPI number
Gender
F
Credential
PSYD, LP
Contact information
Practice address
199 COON RAPIDS BLVD NW, SUITE 310, COON RAPIDS, MN 55433-5831
(763) 785-8111
(763) 785-8111
Mailing address
1416 OAKWOOD DR, ANOKA, MN 55303-2747
(763) 427-6897
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
LP3194
MN
103TC1900X
Counseling Psychologist
LP3194
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
4912233-00
—
MN
Enumeration date
05/15/2006
Last updated
02/28/2019
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