Individual
GRETCHEN E WEATHERLY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHD
Contact information
Practice address
200 UNIVERSITY AVE E, CHILD AND FAMILY SERVICES DEPARTMENT, SAINT PAUL, MN 55101-2507
(651) 229-3855
(651) 602-6891
Mailing address
200 UNIVERSITY AVE E, GILLETTE CHILDRENS SPECIALTY HEALTHCARE, SAINT PAUL, MN 55101
(651) 229-3855
(651) 602-6891
Taxonomy
Speciality
Code
Description
License number
State
103G00000X
Clinical Neuropsychologist
Primary
LP4427
MN
Other
Enumeration date
07/16/2006
Last updated
01/18/2008
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