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Individual

DR. JOHN MARK PRICHARD

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
PH.D.

Contact information

Practice address
1500 MCANDREWS RD W, SUITE 209, BURNSVILLE, MN 55337-4432
(952) 808-3166
(952) 892-1722
Mailing address
1500 MCANDREWS RD W, SUITE 209, BURNSVILLE, MN 55337-4432
(952) 808-3166
(952) 892-1722

Taxonomy

Speciality
Code
Description
License number
State
103TC1900X
Counseling Psychologist
Primary
LP0623
MN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
283551700
MN
01
6133246
MEDICA PROVIDER NUMBER
MN
01
9L867PR
BLUECROSS BLUESHIELD
MN
Enumeration date
08/22/2005
Last updated
12/20/2013
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