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Individual

CHERI L BRUNETTI

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PHD, LP

Contact information

Practice address
21308 JOHN MILLESS DR, SUITE 101B, ROGERS, MN 55374-4708
(763) 428-4060
(763) 428-1711
Mailing address
21308 JOHN MILLESS DR, SUITE 101B, ROGERS, MN 55374-4708
(763) 428-4060
(763) 428-1711

Taxonomy

Speciality
Code
Description
License number
State
103G00000X
Clinical Neuropsychologist
Primary
LP4169
MN
103T00000X
Psychologist
LP4169
MN
103TC0700X
Clinical Psychologist
LP4169
MN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
719220700
MN
Enumeration date
04/19/2006
Last updated
06/29/2009
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