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Individual
ROBIN CAROL BRUNGARD
Active
Individual
ROBIN CAROL BRUNGARD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW-C
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
11218
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
10763028
CAQH
—
01
—
278928-000
MAGELLAN
—
05
—
402796500
—
MD
01
—
604857-02
CAREFIRST BC/BS
MD
01
—
F453-0002
CAREFIRST BLUECHOICE
—
Enumeration date
08/09/2005
Last updated
12/29/2015
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