Austin, John Vincent

Austin, John Vincent is an sole proprietor health care provider with primary practice located at 3048 Fulton Cir , Clearwater MN 55320-1306. He recently has only one registered license in Behavioral Health & Social Service Providers / Psychologist, which is considered as his primary health care specialty. Austin, John Vincent can be contacted via phone (651) 276-9490.

Contact Information

Primary practice address
3048 Fulton Cir Clearwater MN 55320-1306
Fax: (320) 558-4066
Website:

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Psychologist 103T00000X LP2614 Minnesota

Profile Details

NPI number 1336225705
LBN Legal business name Austin, John Vincent
Credentials PH.D.
Entity Individual
Sole proprietor 1 Yes
Enumeration date Oct 28th, 2006
Last updated Jul 6th, 2015 - about 11 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1336225705 NPPES
Minnesota MEDICAID 568847700

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