Provider Demographics
NPI:1386463776
Name:DZUBINSKI, BRICE FREDERICK (JD MA BS)
Entity type:Individual
Prefix:
First Name:BRICE
Middle Name:FREDERICK
Last Name:DZUBINSKI
Suffix:
Gender:M
Credentials:JD MA BS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3601 MINNESOTA DR STE 170
Mailing Address - Street 2:
Mailing Address - City:BLOOMINGTON
Mailing Address - State:MN
Mailing Address - Zip Code:55435-5202
Mailing Address - Country:US
Mailing Address - Phone:612-924-3807
Mailing Address - Fax:
Practice Address - Street 1:3601 MINNESOTA DR STE 170
Practice Address - Street 2:
Practice Address - City:BLOOMINGTON
Practice Address - State:MN
Practice Address - Zip Code:55435-5202
Practice Address - Country:US
Practice Address - Phone:612-924-3807
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-10-03
Last Update Date:2024-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health