Basic Information
| Provider Information | |||||||||
| NPI: | 1275868564 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | MINNIEAR | ||||||||
| FirstName: | ADAM | ||||||||
| MiddleName: | H | ||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | PSY.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 733 W CLAIREMONT AVE | ||||||||
| Address2: | |||||||||
| City: | EAU CLAIRE | ||||||||
| State: | WI | ||||||||
| PostalCode: | 547016101 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6087850940 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 8901 WISCONSIN AVE | ||||||||
| Address2: | |||||||||
| City: | BETHESDA | ||||||||
| State: | MD | ||||||||
| PostalCode: | 208890004 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3014001977 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 10/05/2009 | ||||||||
| LastUpdateDate: | 09/30/2021 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 09/30/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 103TC0700X | 1086 | HI | N | Behavioral Health & Social Service Providers | Psychologist | Clinical | 103TC0700X | 0810004350 | VA | N | Behavioral Health & Social Service Providers | Psychologist | Clinical | 103TC0700X | 3342 | WI | Y | Behavioral Health & Social Service Providers | Psychologist | Clinical |
No ID Information.