Bordewick, Mark C

Bordewick, Mark C is an individual health care provider with primary practice located at 1321 13Th St N , St Cloud MN 56303-2614. He recently has only one registered license in Behavioral Health & Social Service Providers / Psychologist, which is considered as his primary health care specialty. Bordewick, Mark C can be contacted via phone (320) 252-5010.

Contact Information

Primary practice address
1321 13Th St N St Cloud MN 56303-2614
Phone: (320) 252-5010
Fax: (320) 203-1855
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Psychologist 103T00000X LP0984 Minnesota

Profile Details

NPI number 1982648887
LBN Legal business name Bordewick, Mark C
Credentials PHD LP
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 15th, 2006
Last updated Jan 27th, 2010 - about 14 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 1982648887 NPPES
Other 6100032 MEDICA
MEDICAID 095248600 MEDICA
Other 117014C851 MEDICA
Other 922241012150 MEDICA
Other 44544 MEDICA
Other HP25562 MEDICA
Other 03Q37B0 MEDICA

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