Individual
GAUTHAM KRISHNAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
7400 METRO BLVD STE 227, EDINA, MN 55439-2470
(612) 712-5244
Mailing address
6390 DOUGLAS DR N APT 204, BROOKLYN PARK, MN 55429-1980
(612) 900-9385
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Enumeration date
05/15/2024
Last updated
05/15/2024
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