Organization
DENNIS M. BREKKE, LTD.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DENNIS M. BREKKE PH.D. (PRESIDENT/OWNER)
(612) 991-1769
Entity
Organization
Contact information
Practice address
2021 E HENNEPIN AVE, MINNEAPOLIS, MN 55413-1896
(612) 991-1769
(612) 395-5585
Mailing address
10331 108TH PL N, MAPLE GROVE, MN 55369-2638
(612) 991-1769
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
01992BR
BCBS PROVIDER NUMBER
MN
01
—
1H217BR
BCBS PROVIDER NUMBER
MN
05
—
546347500
—
MN
Enumeration date
09/15/2006
Last updated
12/19/2012
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