Brad W Houghton Psyd LP LLC
Point of Service in Saint Paul, MN. Organization (NPI-2).
NPI number1639588643
StatusActive
Last updated in NPPESAug 5, 2014
Details
- NPI
- 1639588643
- Entity type
- Organization (NPI-2)
- Legal business name
- Brad W Houghton Psyd LP LLC
- Organization subpart
- No
- Enumeration date
- Aug 5, 2014
- Last updated
- Aug 5, 2014
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 305S00000X | Point of Service | LP4812 | MN | Yes |
Practice location
821 Raymond AveSaint Paul, MN 55114-1532
Phone 651-645-8300 · Fax 651-645-4603
Mailing address
821 Raymond AveSaint Paul, MN 55114-1532
Phone 651-645-8300 · Fax 651-645-4603
Authorized official
Brad William Houghton
Owner
6123087038
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