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General NPI Number Information
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NPI Number | 1083901128
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Entity Type | Organization
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Legal Business Name | LEVI Y. BREUER, PSY.D.
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Dates
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Enumeration Date | 07/08/2011
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Last Update Date | 07/08/2011
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Provider Practice Location Address
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Address Line | 9650 SANTIAGO RD SUITE 3
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City | COLUMBIA
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State | MD
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Zip | 21045-3957
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Country | US
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Telephone | 410-343-9756
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Fax |
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Provider Business Mailing Address
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Address Line | 6528 CLARINGTON RD
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City | BALTIMORE
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State | MD
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Zip | 21209-3850
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Country | US
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Telephone | 410-343-9756
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Fax |
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Authorized Official
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Title or Position | PSYCHOLOGIST
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Name | DR. LEVI Y. BREUER
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Credential | PSYD
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Telephone | 410-343-9756
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number | 04964
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License Number State | MD
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