Individual
MS. CAROLYN EVELYN BRUNNER
Active
Sole proprietor
Provider details
NPI number
Gender
F
Credential
LICSW
Contact information
Practice address
3009 HOLMES AVE, MINNEAPOLIS, MN 55408-2628
(612) 871-8998
(612) 827-8916
Mailing address
2235 FLORA CT, LINO LAKES, MN 55038-7731
(651) 762-7962
(612) 827-8916
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
01345
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
02188BR
BCBS
MN
01
—
62-20337
UNITED BEHAVIOR HEALTH
MN
Enumeration date
04/26/2006
Last updated
07/09/2007
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