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NPI Code Detail

MEDICARE: GABRIELLE JEAN BREWINGTON

MEDICARE: GABRIELLE JEAN BREWINGTON
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1106S00000XBehavior Technician

General Provider Information

NPI Number : 1508799461
Entity Type Code : Individual
Provider Name (Legal Business Name) : GABRIELLE JEAN BREWINGTON
Provider Business Mailing Address
First Line : 6320 PENN AVE S
Second Line :
City : RICHFIELD
State : MN
Zip : 55423-1139
Country : US
Telephone Number : 612-677-2350
Fax Number :
Provider Business Practice Location Address
First Line : 6320 PENN AVE S
Second Line :
City : RICHFIELD
State : MN
Zip : 55423-1139
Country : US
Telephone Number : 612-677-2350
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/08/2026
Last Update Date : 06/08/2026

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Directions to “ GABRIELLE JEAN BREWINGTON ” Practice Location

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