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NPI 1114197068

NPI 1114197068 : GARY O STEELE M.A. L.M.F.T : SAINT PAUL, MN

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General NPI Number Information
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    NPI Number           |    1114197068
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    Entity Type          |    Individual 
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    Provider Name        |    GARY O STEELE M.A. L.M.F.T
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    Gender               |    Male 
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Dates
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    Enumeration Date     |    03/06/2008
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    Last Update Date     |    07/12/2018
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Provider Practice Location Address
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    Address Line         |    762 TRANSFER RD STE 21 
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    City                 |    SAINT PAUL
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    State                |    MN
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    Zip                  |    55114
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    Country              |    US
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    Telephone            |    651-659-2936
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    Fax                  |    651-645-7306
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Provider Business Mailing Address
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    Address Line         |    762 TRANSFER RD STE 21 
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    City                 |    SAINT PAUL
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    State                |    MN
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    Zip                  |    55114-1489
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    Country              |    US
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    Telephone            |    651-659-2936
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    Fax                  |    651-645-7306
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Authorized Official
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    Title or Position    |    
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    Name                 |        
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    Credential           |    
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    Telephone            |    
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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    Taxonomy Code        |    101YP2500X
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    Taxonomy Name        |    Professional Counselor
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    License Number       |    0916
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    License Number State |    MN
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