Individual
MICHELLE BRUNKE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMSW
Contact information
Practice address
213 N MAIN ST, MOSCOW, ID 83843-2700
(208) 683-8320
(208) 969-8380
Mailing address
148 S COLE RD, BOISE, ID 83709-0932
(208) 683-8320
(208) 969-8380
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
LMSW-6461172
ID
101YM0800X
Mental Health Counselor
LMSW-6461172
ID
104100000X
Social Worker
Primary
LMSW-6461172
ID
Other
Enumeration date
09/24/2024
Last updated
07/21/2025
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