Individual
DR. MICHELLE A BROUILLETTE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHD, LP
Contact information
Practice address
11990 PORTLAND AVE, BURNSVILLE, MN 55337-1516
(612) 462-7053
(952) 479-7896
Mailing address
11990 PORTLAND AVE, BURNSVILLE, MN 55337-1516
(952) 435-8814
(952) 435-7705
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
LP2929
MN
Other
Enumeration date
12/28/2005
Last updated
07/13/2020
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