Provider Demographics
NPI:1215956891
Name:BREUS, MICHAEL JASON (PHD)
Entity type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:JASON
Last Name:BREUS
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9913 N. 95TH ST.
Mailing Address - Street 2:
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85258
Mailing Address - Country:US
Mailing Address - Phone:480-860-8998
Mailing Address - Fax:480-377-9245
Practice Address - Street 1:9913 N. 95TH ST.
Practice Address - Street 2:
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85258
Practice Address - Country:US
Practice Address - Phone:480-860-8998
Practice Address - Fax:480-377-9245
Is Sole Proprietor?:No
Enumeration Date:2006-07-18
Last Update Date:2012-11-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ3760103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ3760OtherAZ BOARD OF PSYCHOLOGIST