Bertucci, Mark Dominic
Bertucci, Mark Dominic is an individual health care provider with primary practice located at 675 E Nicollet Blvd Ste 250 , Burnsville MN 55337-6768. He recently has only one registered license in Behavioral Health & Social Service Providers / Clinical, which is considered as his primary health care specialty. Bertucci, Mark Dominic can be contacted via phone (952) 993-3307.Contact Information
Primary practice address
675 E Nicollet Blvd Ste 250
Burnsville MN 55337-6768
Phone: (952) 993-3307
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Clinical | 103TC0700X | LP6174 | Minnesota |
Profile Details
| NPI number | 1376055665 |
|---|---|
| LBN Legal business name | Bertucci, Mark Dominic |
| Credentials | PSYD, LP |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Oct 26th, 2017 |
| Last updated | Mar 17th, 2018 - about 7 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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