Provider Demographics
NPI:1801493952
Name:BROWNFIELD, MICHELLE (PSYD, LP)
Entity type:Individual
Prefix:
First Name:MICHELLE
Middle Name:
Last Name:BROWNFIELD
Suffix:
Gender:F
Credentials:PSYD, LP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1346 W ARROWHEAD RD STE 247
Mailing Address - Street 2:
Mailing Address - City:DULUTH
Mailing Address - State:MN
Mailing Address - Zip Code:55811-2218
Mailing Address - Country:US
Mailing Address - Phone:218-206-2021
Mailing Address - Fax:
Practice Address - Street 1:1346 W ARROWHEAD RD STE 247
Practice Address - Street 2:
Practice Address - City:DULUTH
Practice Address - State:MN
Practice Address - Zip Code:55811-2218
Practice Address - Country:US
Practice Address - Phone:218-206-2021
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-10-01
Last Update Date:2021-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MNLP6380103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Multi-Specialty