Brownell Mack III PSYD

NPI 1023095627 - Psychologist - 103T00000X

NPI Details
NPI 1023095627
Gender Male
Enumeration Date 12/27/2005
Last Updated 07/08/2007
Entity Type Individual
Active Over 10 years ago
Practice Location
1313 PENN AVE N
MINNEAPOLIS MN, 55411-3047, US
Phone (612) 302-4600
Fax
Business Location
1313 PENN AVE N
MINNEAPOLIS MN, 55411-3047, US
Phone (612) 302-4600
Fax
Toxanomy
Taxonomy Code 103T00000X
License State Minnesota
License Number LP4548
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According to our database, Brownell Mack III PSYD NPI is 1023095627, taxonomy code is 103T00000X and license number is LP4548, license state is located at Minnesota. Brownell Mack III PSYD physically located at 1313 Penn Ave N, Minneapolis MN, 55411-3047. NPI Number Brownell Mack III PSYD has the Individual type.

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1023095627 NPI number is provided on an as is basis without warranty of any kind. 1023095627 is maintained by the National Plan & Provider Enumeration System. The contents of Brownell Mack III PSYD are for informational purposes only.