IndividualActive
Brian Gatheridge, PHD
NPI 1043465644 · Psychologist · Detroit Lakes, MN
Provider details
- NPI number
- 1043465644
- Entity type
- Individual
- Primary specialty
- PsychologistBehavioral Health & Social Service Providers
- Credential
- PHD
- Sex
- Male
- Sole proprietor
- No
Specialties & taxonomies
Behavioral Health & Social Service Providers
- Clinical Child & Adolescent Psychologist103TC2200X
Behavioral Health & Social Service Providers
Practice location
1245 Washington Ave
Detroit Lakes, MN 56501-3905
Phone: (218) 846-2000
Approximate (ZIP-level) locationGet directions
Mailing address
1219 S. Washington Ave
Detroit Lakes, MN 56501-3905
Registry dates
- Enumerated
- 2008-11-24
- Last updated
- 2022-04-04
- Certified
- 2022-04-04
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.