Breitenbucher, Thomas Arthur

Breitenbucher, Thomas Arthur is an individual health care provider with primary practice located at 6120 Earle Brown Dr Suite 520, Brooklyn Center MN 55430-2123. He recently has 2 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Mental Health, Behavioral Health & Social Service Providers / Clinical. Behavioral Health & Social Service Providers / Clinical is his primary health care specialty. Breitenbucher, Thomas Arthur can be contacted via phone (763) 531-0566.

Contact Information

Primary practice address
6120 Earle Brown Dr Suite 520 Brooklyn Center MN 55430-2123
Phone: (763) 531-0566
Fax: (763) 531-0602
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Mental Health 101YM0800X LP2794 Minnesota
Behavioral Health & Social Service Providers / Clinical 103TC0700X LP2794 Minnesota

Profile Details

NPI number 1699846154
LBN Legal business name Breitenbucher, Thomas Arthur
Credentials PH.D., L.P.
Entity Individual
Sole proprietor 1 No
Enumeration date Nov 13th, 2006
Last updated Nov 17th, 2016 - about 8 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 1699846154 NPPES
Minnesota Other 104654 UCARE
Minnesota Other 54R37BR UCARE
Minnesota MEDICAID 433853700 UCARE
Minnesota Other 61-16175 UCARE

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