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Individual

JUDY KAY BRUNSGAARD

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
LICSW

Contact information

Practice address
7236 FORESTVIEW LN N, MAPLE GROVE, MN 55369-5656
(763) 416-4167
(763) 416-4137
Mailing address
7236 FORESTVIEW LN N, MAPLE GROVE, MN 55369-5656
(763) 416-4167
(763) 416-4137

Taxonomy

Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
19209
MN
1041C0700X
Clinical Social Worker
7902-123
WI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1306115969
MN
Enumeration date
12/27/2011
Last updated
12/13/2015
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