Individual
SCOTT CALLAN MIMNAUGH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MA
Contact information
Practice address
303 5TH AVE RM 1503, NEW YORK, NY 10016-6666
(212) 506-5935
Mailing address
751 SAINT MARKS AVE APT D5, BROOKLYN, NY 11216-3750
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
026227
NY
Other
Enumeration date
07/31/2019
Last updated
02/07/2024
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