Individual
ELIANA M DEANGELIS BRUNNER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPAT
Contact information
Practice address
3630 DUTCHMANS LN FL 2, LOUISVILLE, KY 40205-3216
(502) 523-7565
Mailing address
2306 WOODBOURNE AVE APT 5, LOUISVILLE, KY 40205-1754
(502) 523-7565
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
KY-0126
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
KY-0126
—
KY
Enumeration date
05/01/2012
Last updated
12/04/2017
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