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Individual

GARY D EUSTICE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
MS LP

Contact information

Practice address
302 E HOWARD ST, SUITE 309, HIBBING, MN 55746-1772
(218) 966-5385
Mailing address
3920 13TH AVE E, SUITE 6, HIBBING, MN 55746-3675
(218) 263-7540

Taxonomy

Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
LP2919
MN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
160553400
MN
Enumeration date
09/26/2006
Last updated
07/09/2014
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