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General NPI Number Information
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NPI Number | 1073773651
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Entity Type | Organization
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Legal Business Name | JOHN HONEBRINK
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Dates
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Enumeration Date | 06/17/2008
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Last Update Date | 07/22/2008
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Provider Practice Location Address
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Address Line | 1700 W HWY 36 210 ROSEDALE TOWERS
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City | ROSEVILLE
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State | MN
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Zip | 55113
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Country | US
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Telephone | 651-490-9920
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Fax | 651-578-1125
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Provider Business Mailing Address
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Address Line | 1700 W HWY 36 210 ROSEDALE TOWERS
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City | ROSEVILLE
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State | MN
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Zip | 55113
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Country | US
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Telephone | 651-490-9920
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Fax | 651-578-1125
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | MRS. JANET MARIE MEULEMANS
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Credential |
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Telephone | 651-307-7865
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103T00000X
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Taxonomy Name | Psychologist
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License Number | LP1354
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License Number State | MN
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