Clyde William Ekbom in Duluth - Clinical
Clyde William Ekbom - NPI 1174727614
Clyde William Ekbom is a Clinical in Duluth, Minnesota. Clyde William Ekbom practices all healthcare services and medical treatments related to Clinical. The NPI Number for Clyde William Ekbom is 1174727614. The last update date is 2012-05-23.
Clyde William Ekbom's current location address is 1401 East First Street, Duluth, Minnesota. You can contact this provider via phone number 2187284404 and fax number 2187284404. The mailing address for Clyde William Ekbom is 1401 East First Street, Duluth, Minnesota. To know further, please read the information below!
Provider Profile Detail
| Provider Name | Clyde William Ekbom |
|---|---|
| Address | 1401 East First Street, Duluth, Minnesota |
| Phone Number | 2187284404 |
| Fax Number | 2187284404 |
| Sole Proprietor | N |
| Credentials | ED.D., LP |
NPI Number Detail
| NPI Number | 1174727614 |
|---|---|
| Provider Enumeration Date | 2007-06-11 |
| Last Updated Date | 2012-05-23 |
Provider Mailing Address Detail
| Address | 1401 East First Street |
|---|---|
| City | Duluth |
| State | Minnesota (MN) |
| Post Code | 55805 |
| Phone Number | 2187284404 |
| Fax Number | 2187284404 |
Provider's Primary Taxonomy Detail
| Speciality | Clinical |
|---|---|
| Taxonomy | 103Tc0700X |
| Licence No | LP0266 |
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Definition: A psychologist who provides continuing and comprehensive mental and behavioral health care for individuals and families; consultation to agencies and communities; training, education and supervision; and research-based practice. It is a specialty in |
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What is the Clyde William Ekbom's 1174727614?
The Clyde William Ekbom's NPI (National Provider Identifier) Number is 1174727614. This unique 10-digit identification number is assigned to health care providers by the Centers for Medicare & Medicaid Services (CMS).
Where is the Clyde William Ekbom located?
The Clyde William Ekbom is located at 1401 East First Street, Duluth, MN 55805.
What is Clyde William Ekbom's primary field of medical specialization, and what is the corresponding taxonomy classification code for this area of expertise?
The primary field of medical specialization for Clyde William Ekbom is Clinical, and the taxonomy classification code that categorizes this area of expertise is 103Tc0700X.
On what date did the Clyde William Ekbom receive the assignment of its 1174727614 from the Centers for Medicare & Medicaid Services?
The Clyde William Ekbom was issued its 1174727614 by the Centers for Medicare & Medicaid Services on 2007-06-11.
When was the information regarding Clyde William Ekbom most recently updated?
The details pertaining to the Clyde William Ekbom, including its address, specialty, and other relevant information, were last refreshed on 2012-05-23.