Deangelis Brunner, Eliana M
Deangelis Brunner, Eliana M is an sole proprietor health care provider with primary practice located at 3630 Dutchmans Ln Fl 2 , Louisville KY 40205-3216. She recently has only one registered license in Behavioral Health & Social Service Providers / Mental Health, which is considered as her primary health care specialty. Deangelis Brunner, Eliana M can be contacted via phone (502) 523-7565.Contact Information
Primary practice address
3630 Dutchmans Ln Fl 2
Louisville KY 40205-3216
Phone: (502) 523-7565
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Mental Health | 101YM0800X | KY-0126 | Kentucky |
Profile Details
| NPI number | 1457619157 |
|---|---|
| LBN Legal business name | Deangelis Brunner, Eliana M |
| Credentials | LPAT |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | May 1st, 2012 |
| Last updated | Dec 4th, 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1457619157 | NPPES |
| Kentucky | MEDICAID | KY-0126 |
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