Provider Demographics
NPI:1982132122
Name:DEBBIE B KROVITZ MA LP INC
Entity Type:Organization
Organization Name:DEBBIE B KROVITZ MA LP INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:DEBBIE
Authorized Official - Middle Name:B
Authorized Official - Last Name:KROVITZ
Authorized Official - Suffix:
Authorized Official - Credentials:LP
Authorized Official - Phone:612-872-4001
Mailing Address - Street 1:212 RIDGEWOOD AVE
Mailing Address - Street 2:
Mailing Address - City:MINNEAPOLIS
Mailing Address - State:MN
Mailing Address - Zip Code:55403-3507
Mailing Address - Country:US
Mailing Address - Phone:612-872-4001
Mailing Address - Fax:
Practice Address - Street 1:212 RIDGEWOOD AVE
Practice Address - Street 2:
Practice Address - City:MINNEAPOLIS
Practice Address - State:MN
Practice Address - Zip Code:55403-3507
Practice Address - Country:US
Practice Address - Phone:612-872-4001
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-06-01
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Single Specialty