Bruce Lee Bakke in Brooklyn Center - Intellectual And Developmental Disabilities

Bruce Lee Bakke - NPI 1184767675

Bruce Lee Bakke is a Intellectual And Developmental Disabilities in Brooklyn Center, Minnesota. Bruce Lee Bakke practices all healthcare services and medical treatments related to Intellectual And Developmental Disabilities. The NPI Number for Bruce Lee Bakke is 1184767675. The last update date is 2010-06-22.

Bruce Lee Bakke's current location address is 3300 County Road 10, Brooklyn Center, Minnesota. You can contact this provider via phone number 7635608331 and fax number 7635608431. The mailing address for Bruce Lee Bakke is 3300 County Road 10, Brooklyn Center, Minnesota. To know further, please read the information below!

Provider Profile Detail

Provider Name Bruce Lee Bakke
Address 3300 County Road 10, Brooklyn Center, Minnesota
Phone Number 7635608331
Fax Number 7635608431
Sole Proprietor Y
Credentials PH.D.

NPI Number Detail

NPI Number 1184767675
Provider Enumeration Date 2007-02-14
Last Updated Date 2010-06-22

Provider Mailing Address Detail

Address 3300 County Road 10
City Brooklyn Center
State Minnesota (MN)
Post Code 554293072
Phone Number 7635608331
Fax Number 7635608431

Provider's Primary Taxonomy Detail

Speciality Intellectual And Developmental Disabilities
Taxonomy 103Tm1800X
Licence No LP2204
Definition:
A psychologist who works with people who have cognitive impairments and developmental disabilities.

Provider's Other Legacy Identifiers

Identifier Identifier Type Identifier State Identifier Issuer
866750100 MN --

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FAQs about Bruce Lee Bakke

What is the unique 10-digit identifier code issued to Bruce Lee Bakke by the Centers for Medicare & Medicaid Services?

The Bruce Lee Bakke has been assigned the NPI (National Provider Identifier) 1184767675 by the CMS (Centers for Medicare & Medicaid Services). This 10-digit code serves as a unique identification number for healthcare providers.

Could you provide the complete physical address where Bruce Lee Bakke is located?

The Bruce Lee Bakke is situated at the following address: 3300 County Road 10, Brooklyn Center, MN, 554293072.

What is Bruce Lee Bakke's specialized field of practice, and what is the corresponding taxonomy classification code?

The Bruce Lee Bakke's area of specialization is Intellectual And Developmental Disabilities, and the corresponding taxonomy code that categorizes this field of practice is 103Tm1800X.

On what date did the Centers for Medicare & Medicaid Services assign the 1184767675 to Bruce Lee Bakke?

The Centers for Medicare & Medicaid Services assigned the 1184767675 to Bruce Lee Bakke on 2007-02-14.

When was the information regarding Bruce Lee Bakke, such as address, specialty, and other details, most recently verified or confirmed to be accurate?

The information pertaining to Bruce Lee Bakke, including its address, specialty, and other relevant details, was most recently verified or confirmed to be accurate on 2010-06-22.

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