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General NPI Number Information
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NPI Number | 1790897288
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Entity Type | Individual
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Provider Name | LINDA S BREVITZ DO
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Gender | Female
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Dates
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Enumeration Date | 08/31/2006
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Last Update Date | 02/16/2016
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Provider Practice Location Address
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Address Line | 640 JACKSON ST HP REGIONS BEHAVIORAL HEALTH
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City | SAINT PAUL
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State | MN
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Zip | 55101-2502
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Country | US
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Telephone | 651-254-4786
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Fax | 651-254-9426
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Provider Business Mailing Address
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Address Line | 8170 33RD AVE S MS21110Q
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City | MINNEAPOLIS
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State | MN
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Zip | 55425-4516
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Country | US
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Telephone | 800-968-6866
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Fax | 616-532-7230
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | 5101013252
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License Number State | MI
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Taxonomy #2
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | 50384
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License Number State | MN
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