Organization
BRIH DESIGN LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
STACY DEMARANVILLE (BUSINESS MANAGER)
(612) 522-3945
Entity
Organization
Contact information
Practice address
4535 WASHBURN AVE N, MINNEAPOLIS, MN 55412-1055
(612) 522-3945
(612) 522-5124
Mailing address
4535 WASHBURN AVE N, MINNEAPOLIS, MN 55412-1055
(612) 522-3945
(612) 522-5124
Taxonomy
Speciality
Code
Description
License number
State
103TB0200X
Cognitive & Behavioral Psychologist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
60D83OS
BLUECROSSBLUESHEILD GRP#
MN
Enumeration date
12/29/2006
Last updated
08/22/2020
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