Provider Demographics
NPI:1770883423
Name:GETTY, PARIS DON REY
Entity type:Individual
Prefix:
First Name:PARIS
Middle Name:DON REY
Last Name:GETTY
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:720 E LAKE ST
Mailing Address - Street 2:
Mailing Address - City:MINNEAPOLIS
Mailing Address - State:MN
Mailing Address - Zip Code:55407-1547
Mailing Address - Country:US
Mailing Address - Phone:612-746-3500
Mailing Address - Fax:612-871-1058
Practice Address - Street 1:720 E LAKE ST
Practice Address - Street 2:
Practice Address - City:MINNEAPOLIS
Practice Address - State:MN
Practice Address - Zip Code:55407-1547
Practice Address - Country:US
Practice Address - Phone:612-746-3500
Practice Address - Fax:612-871-1058
Is Sole Proprietor?:No
Enumeration Date:2010-10-28
Last Update Date:2010-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN302980101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)