Drew, Douglas Alan

Drew, Douglas Alan is an sole proprietor health care provider with primary practice located at 10190 Baltimore St Ne Suite 110, Blaine MN 55449-5056. He recently has only one registered license in Behavioral Health & Social Service Providers / Clinical, which is considered as his primary health care specialty. Drew, Douglas Alan can be contacted via phone (763) 755-7612.

Contact Information

Primary practice address
10190 Baltimore St Ne Suite 110 Blaine MN 55449-5056
Fax: (763) 775-2048
Website:

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Clinical 1041C0700X 7998 Minnesota

Profile Details

NPI number 1376534214
LBN Legal business name Drew, Douglas Alan
Credentials MA, LICSW
Entity Individual
Sole proprietor 1 Yes
Enumeration date Oct 31st, 2005
Last updated Jul 8th, 2007 - about 19 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1376534214 NPPES
Minnesota MEDICAID 141257400

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