Healthcare Provider Details

I. General information

NPI: 1073371829
Provider Name (Legal Business Name): BREE ZAFFKE
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/07/2024
Last Update Date: 03/07/2024
Certification Date: 03/07/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

38508 8TH AVE
NORTH BRANCH MN
55056-3304
US

IV. Provider business mailing address

38508 8TH AVE
NORTH BRANCH MN
55056-3304
US

V. Phone/Fax

Practice location:
  • Phone: 651-442-3446
  • Fax:
Mailing address:
  • Phone: 651-442-3446
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number22714
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: