Dr. Bruce Lee Bakke
Psychologist Cognitive & Behavioral Psychologist Adult Development & Aging Psychologist Intellectual & Developmental Disabilities
3300 County Road 10 Suite 500
Brooklyn Center
, Minnesota 55429-3072
Dr. Bruce Lee Bakke
Psychologist Cognitive & Behavioral Psychologist Adult Development & Aging Psychologist Intellectual & Developmental Disabilities
3300 County Road 10 Suite 500
Brooklyn Center
, Minnesota 55429-3072
(651) 645-3949
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About
Features
Specialties
- Psychologist
- Adult Development & Aging Psychologist
- Cognitive & Behavioral Psychologist
- Intellectual & Developmental Disabilities
Languages spoken
- English
Location
First Address
- Dr. Bruce Lee Bakke
- 2012 Iglehart Ave
- Saint Paul, MN
- Zip : 55104-5146
- Fax : (651) 645-3949
- Phone : (651) 645-3949
Second Address
- Dr. Bruce Lee Bakke
- 3300 County Road 10 Suite 500
- Brooklyn Center, MN
- Zip : 55429-3072
- Fax : (763) 560-8431
- Phone : (763) 560-8331
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 102L00000X | Psychologist | LP2204 | MN |
| Y | 103T00000X | Psychologist | LP2204 | MN |
| N | 103TA0700X | Adult Development & Aging Psychologist | LP2204 | MN |
| N | 103TB0200X | Cognitive & Behavioral Psychologist | LP2204 | MN |
| N | 103TM1800X | Intellectual & Developmental Disabilities | LP2204 | MN |
National Provider Identifier
| NPI | 1184767675 |
|---|---|
| Provider Name | Dr. Bruce Lee Bakke |
| First Address | Saint Paul, MN 55104-5146 |
| Second Address | Brooklyn Center, MN 55429-3072 |
| Gender | M |
| NPI Entity type | Individual |
| Is Sole Proprietor | Yes |
| Is Organization Subpart | N/A |
| Enumeration Date | 14/02/2007 |
| Last Update Date | 22/06/2010 |
Additional Identifiers
| IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
|---|---|---|
| 866750100 | (05) | MN |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.