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:
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Health care specialties

SpecialtyCodeLicense #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 5 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 1346805066 NPPES
Utah Other 10464447-2501 LICENSE

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