Individual
DR. MICHAEL S. BUTCHKO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PH.D.
Contact information
Practice address
2265 COMO AVE, SAINT PAUL, MN 55108-1737
(651) 645-5323
Mailing address
11145 BALTIMORE ST NE UNIT G, BLAINE, MN 55449-4879
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
6315
MN
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
07/12/2017
Last updated
12/28/2018
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