Individual
JOHN BERNARD MISCHKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MA LP
Contact information
Practice address
821 RAYMOND AVE, SUITE 300, SAINT PAUL, MN 55114-1503
(651) 647-0659
(651) 647-0659
Mailing address
480 WHEELOCK PKWY W, SAINT PAUL, MN 55117-4258
(651) 489-0149
(651) 654-7065
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
2396
MN
Other
Enumeration date
12/06/2006
Last updated
07/08/2007
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