Mahanaim Psychology Services, Pllc
NPI #1033525423 in Deer Park, Washington
Provider Information
- NPI Number
- 1033525423
- Entity Type
- Organization
- Organization Name
- Mahanaim Psychology Services, Pllc
- Primary Specialty
- Psychologist - Clinical
- Enumeration Date
- Jul 7, 2014
- Last Updated
- Nov 19, 2019
Practice Location
- Address
- 110 W CRAWFORD ST STE F
- City
- Deer Park
- State
- Washington
- ZIP Code
- 99006-5356
- Phone
- (509) 276-5644
Authorized Official
- Name
- DR. LESLIE G BROST, PSYD
- Title
- PRESIDENT OF CORPORATION/PROVIDER
- Phone
- (509) 276-5644
Specialties & Taxonomy Codes
| Specialty |
|---|
| Psychologist - Clinical — Clinical |
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