Organization
BRAD W HOUGHTON PSYD LP LLC
Active
Organization
BRAD W HOUGHTON PSYD LP LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BRAD WILLIAM HOUGHTON PSYD LP (OWNER)
(612) 308-7038
Entity
Organization
Contact information
Practice address
821 RAYMOND AVE, SAINT PAUL, MN 55114-1532
(651) 645-8300
(651) 645-4603
Mailing address
821 RAYMOND AVE, SAINT PAUL, MN 55114-1532
(651) 645-8300
(651) 645-4603
Taxonomy
Speciality
Code
Description
License number
State
305S00000X
Point of Service
Primary
LP4812
MN
Other
Enumeration date
08/05/2014
Last updated
08/05/2014
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