Brunner, Michael David

Brunner, Michael David is an individual health care provider with primary practice located at 445 Etna St , Saint Paul MN 55106-5857. He recently has only one registered license in Behavioral Health & Social Service Providers / Psychologist, which is considered as his primary health care specialty. Brunner, Michael David can be contacted via phone (651) 254-4804.

Contact Information

Primary practice address
445 Etna St Saint Paul MN 55106-5857
Fax:
Website:

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Psychologist 103T00000X LP4417 Minnesota

Profile Details

NPI number 1093794349
LBN Legal business name Brunner, Michael David
Credentials PHD
Entity Individual
Sole proprietor 1 No
Enumeration date Jan 14th, 2006
Last updated May 12th, 2017 - about 9 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1093794349 NPPES
Minnesota MEDICAID 175177800

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