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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