Individual
STEVEN MAX VINCENT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHD LP
Contact information
Practice address
1406 6TH AVENUE NORTH, ST CLOUD HOSPITAL, ST CLOUD, MN 56303-1901
(320) 251-2700
(320) 229-5109
Mailing address
1406 6TH AVENUE NORTH, ST CLOUD HOSPITAL, ST CLOUD, MN 56303-1901
(320) 251-2700
(320) 229-5109
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
1137
MN
103TC0700X
Clinical Psychologist
LP1137
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
273048100
—
MN
Enumeration date
05/05/2006
Last updated
10/10/2017
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