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Individual

ELAINE J BRUCKNER

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
PH.D.

Contact information

Practice address
970 W WOOSTER ST, SUITE 124, BOWLING GREEN, OH 43402-2643
(419) 352-6666
(419) 353-1117
Mailing address
970 W WOOSTER ST, SUITE 124, BOWLING GREEN, OH 43402-2643
(419) 352-6666
(419) 353-1117

Taxonomy

Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
5040
OH

Other

Enumeration date
10/24/2006
Last updated
07/08/2007
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