Brokaw, Susan P

Brokaw, Susan P is an sole proprietor health care provider with primary practice located at 5100 Thimsen Ave Suite 130, Minnetonka MN 55345-4108. She recently has only one registered license in Behavioral Health & Social Service Providers / Marriage & Family Therapist, which is considered as her primary health care specialty. Brokaw, Susan P can be contacted via phone (952) 933-9926.

Contact Information

Primary practice address
5100 Thimsen Ave Suite 130 Minnetonka MN 55345-4108
Phone: (952) 933-9926
Fax: (952) 474-3558
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Marriage & Family Therapist 106H00000X 0013 Minnesota

Profile Details

NPI number 1356555346
LBN Legal business name Brokaw, Susan P
Credentials
Entity Individual
Sole proprietor 1 Yes
Enumeration date May 9th, 2007
Last updated Jul 8th, 2007 - about 19 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 1356555346 NPPES
Minnesota Other ON289PY BLUE CROSS BLUE SHIELD

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