Bakke, Bruce Lee

Bakke, Bruce Lee is an sole proprietor health care provider with primary practice located at 3300 County Road 10 Suite 500, Brooklyn Center MN 55429-3072. He recently has 4 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Psychologist, Behavioral Health & Social Service Providers / Adult Development & Aging, Behavioral Health & Social Service Providers / Cognitive & Behavioral, Behavioral Health & Social Service Providers / Mental Retardation & Developmental Disabilities. Behavioral Health & Social Service Providers / Psychologist is his primary health care specialty. Bakke, Bruce Lee can be contacted via phone (763) 560-8331.

Contact Information

Primary practice address
3300 County Road 10 Suite 500 Brooklyn Center MN 55429-3072
Phone: (763) 560-8331
Fax: (763) 560-8431
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Psychologist 103T00000X LP2204 Minnesota
Behavioral Health & Social Service Providers / Adult Development & Aging 103TA0700X LP2204 Minnesota
Behavioral Health & Social Service Providers / Cognitive & Behavioral 103TB0200X LP2204 Minnesota
Behavioral Health & Social Service Providers / Mental Retardation & Developmental Disabilities 103TM1800X LP2204 Minnesota

Profile Details

NPI number 1184767675
LBN Legal business name Bakke, Bruce Lee
Credentials PH.D.
Entity Individual
Sole proprietor 1 Yes
Enumeration date Feb 14th, 2007
Last updated Jun 22nd, 2010 - about 14 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1184767675 NPPES
Minnesota MEDICAID 866750100

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