Individual
HEIDI KIRSTEN BRUDER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
156 30TH ST NE, BEMIDJI, MN 56601-5660
(480) 431-1589
Mailing address
483 SEED FARM RD, SACATON, AZ 85147
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
28455
MN
104100000X
Social Worker
LMSW-11285
AZ
Other
Enumeration date
03/07/2018
Last updated
02/03/2022
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