| Mahanaim Psychology Services, Pllc | |
|
110 W Crawford St Ste F Deer Park WA 99006-5356 | |
| (509) 276-5644 | |
| (509) 780-4394 |
| Full Name | Mahanaim Psychology Services, Pllc |
|---|---|
| Speciality | Psychologist - Clinical |
| Location | 110 W Crawford St Ste F, Deer Park, Washington |
| Authorized Official Name and Position | Leslie G Brost (PRESIDENT OF CORPORATION/PROVIDER) |
| Authorized Official Contact | 5092765644 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Mahanaim Psychology Services, Pllc Po Box 2110 Deer Park WA 99006-2110 Ph: (509) 276-5644 | Mahanaim Psychology Services, Pllc 110 W Crawford St Ste F Deer Park WA 99006-5356 Ph: (509) 276-5644 |
| NPI Number | 1033525423 |
|---|---|
| Provider Enumeration Date | 07/07/2014 |
| Last Update Date | 11/19/2019 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1033525423 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TC0700X | Psychologist - Clinical | (* (Not Available)) | Primary |
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