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Organization

MAHANAIM PSYCHOLOGY SERVICES, PLLC

Active
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Organization

MAHANAIM PSYCHOLOGY SERVICES, PLLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. LESLIE G BROST PSYD (PRESIDENT OF CORPORATION/PROVIDER)
(509) 276-5644
Entity
Organization

Contact information

Practice address
110 W CRAWFORD ST STE F, DEER PARK, WA 99006-5356
(509) 276-5644
(509) 780-4394
Mailing address
PO BOX 2110, DEER PARK, WA 99006-2110
(509) 276-5644
(509) 276-5644

Taxonomy

Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary

Other

Enumeration date
07/07/2014
Last updated
11/19/2019
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