Gredvig, Vian Maureen
Gredvig, Vian Maureen is an sole proprietor health care provider with primary practice located at 1001 Twelve Oaks Center Dr Ste 1030D , Wayzata MN 55391-4320. She recently has only one registered license in Behavioral Health & Social Service Providers / Clinical, which is considered as her primary health care specialty. Gredvig, Vian Maureen can be contacted via phone (952) 224-4862.Contact Information
Primary practice address
1001 Twelve Oaks Center Dr Ste 1030D
Wayzata MN 55391-4320
Phone: (952) 224-4862
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Clinical | 1041C0700X | ||
| Behavioral Health & Social Service Providers / Clinical | 1041C0700X | 6577 | Minnesota |
| Behavioral Health & Social Service Providers / Clinical | 1041C0700X | 06577 | Minnesota |
Profile Details
| NPI number | 1942246806 |
|---|---|
| LBN Legal business name | Gredvig, Vian Maureen |
| Credentials | MSW, LICSW |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Jun 21st, 2006 |
| Last updated | Feb 4th, 2023 - about 3 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1942246806 | NPPES |
| Minnesota | MEDICAID | H100234918 | |
| Minnesota | Other | H400234929 | |
| Minnesota | MEDICAID | 1942246806 | |
| Minnesota | MEDICAID | 1942683669 |
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