Individual
DR. DUSTIN BROCKBERG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHD
Contact information
Practice address
800 E 28TH ST STE 1750, MINNEAPOLIS, MN 55407-3723
(612) 863-4495
Mailing address
2925 CHICAGO AVE, MINNEAPOLIS, MN 55407-1321
(612) 262-9000
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
LP6577
MN
Other
Enumeration date
03/20/2020
Last updated
04/27/2023
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