Male or Other

Michael D. Brunner PHD

Psychologist in Saint Paul, MN(View on Map)

Full Name

Michael David Brunner PHD

NPI Number

1093794349

NPI Type

Individual Provider

Gender

Male

Enumeration Date

01/14/2006

Specialties

(Taxonomies)

Code

103T00000X

Primary Taxonomy

Yes

Licenses

State

Minnesota

License Number

LP4417

Contact
Information

Purpose

Mailing
Location

Address

445 ETNA ST
445 ETNA ST

City

Saint Paul
Saint Paul

State

MN
MN

Postal Code

55106-5857
55106-5857

Country

US
US

Telephone Number

(651) 254-4804
(651) 254-4804

Identifiers

Identifier

175177800

Identifier State

MN

Identifier Issuer

Unknown

Provider data last refreshed from NPPES NPI registry on 11/19/2024

Data last updated by provider on 05/12/2017

Provider Address

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