Provider Demographics
NPI:1588088405
Name:BREER, JEFFREY (MSW, LICSW)
Entity type:Individual
Prefix:
First Name:JEFFREY
Middle Name:
Last Name:BREER
Suffix:
Gender:M
Credentials:MSW, LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:104 CROSIER DR
Mailing Address - Street 2:
Mailing Address - City:ONAMIA
Mailing Address - State:MN
Mailing Address - Zip Code:56359-4512
Mailing Address - Country:US
Mailing Address - Phone:320-532-3103
Mailing Address - Fax:320-532-5222
Practice Address - Street 1:407 130TH AVE S
Practice Address - Street 2:
Practice Address - City:ONAMIA
Practice Address - State:MN
Practice Address - Zip Code:56359-3115
Practice Address - Country:US
Practice Address - Phone:320-532-4005
Practice Address - Fax:320-532-4898
Is Sole Proprietor?:No
Enumeration Date:2014-02-12
Last Update Date:2014-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN112291041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical