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Individual

DR. THOMAS ARTHUR BREITENBUCHER

Active
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Individual

DR. THOMAS ARTHUR BREITENBUCHER

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
PH.D., L.P.

Taxonomy

Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
LP2794
MN
103TC0700X
Clinical Psychologist
Primary
LP2794
MN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
104654
UCARE
MN
05
433853700
MN
01
54R37BR
BLUECROSSBLUESHIELD
MN
01
61-16175
MEDICA
MN
Enumeration date
11/13/2006
Last updated
11/17/2016
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