Individual
LINDA S BREVITZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DO
Contact information
Practice address
640 JACKSON ST, HP REGIONS BEHAVIORAL HEALTH, SAINT PAUL, MN 55101-2502
(651) 254-4786
(651) 254-9426
Mailing address
8170 33RD AVE S, MS21110Q, MINNEAPOLIS, MN 55425-4516
(800) 968-6866
(616) 532-7230
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
50384
MN
2084P0800X
Psychiatry Physician
5101013252
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
4924716
—
MI
01
—
LB013252
BLUE CROSS BLUE SHIELD
—
Enumeration date
08/31/2006
Last updated
02/16/2016
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