Mcclain, Maryellen Katherine Brunson
Mcclain, Maryellen Katherine Brunson is an individual health care provider with primary practice located at 6405 Old Main Hill , Logan UT 84322-0001. She recently has only one registered license in Behavioral Health & Social Service Providers / Clinical Child & Adolescent, which is considered as her primary health care specialty. Mcclain, Maryellen Katherine Brunson can be contacted via phone (435) 797-1346.Contact Information
Primary practice address
6405 Old Main Hill
Logan UT 84322-0001
Phone: (435) 797-1346
Fax: (844) 308-5865
Website:
Health care specialties
Specialty | Code | License # | State |
---|---|---|---|
Behavioral Health & Social Service Providers / Clinical Child & Adolescent | 103TC2200X |
Profile Details
NPI number | 1346805066 |
---|---|
LBN Legal business name | Mcclain, Maryellen Katherine Brunson |
Credentials | PHD-LP |
Entity | Individual |
Sole proprietor 1 | No |
Enumeration date | May 8th, 2019 |
Last updated | May 8th, 2019 - about 6 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.
Identifiers
State | Type | Number | Issuer |
---|---|---|---|
All States | NPI | 1346805066 | NPPES |
Utah | Other | 10464447-2501 | LICENSE |
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