Individual
DEREK EVAN PROWE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PSYD
Contact information
Practice address
4749 CHICAGO AVE STE 1D, MINNEAPOLIS, MN 55407-4181
(612) 656-9122
Mailing address
4749 CHICAGO AVE STE 1D, MINNEAPOLIS, MN 55407-4181
(612) 656-9122
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
LP5238
MN
Other
Enumeration date
09/15/2008
Last updated
02/25/2016
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