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Individual

KATHLEEN BRUNICK

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
OTR

Contact information

Practice address
6936 GARLAND LN N, MAPLE GROVE, MN 55311-4642
(763) 416-9313
(763) 416-4530
Mailing address
6936 GARLAND LN N, MAPLE GROVE, MN 55311-4642
(763) 416-9313
(763) 416-4530

Taxonomy

Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
102791
MN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
102791
OCCUPATIONAL THERAPIST
MN
Enumeration date
05/16/2018
Last updated
05/16/2018
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