Individual
MS. BRAD GRUNERT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHD
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
921
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
002000220G
HUMANA
—
05
—
1588615330
—
WI
Enumeration date
05/15/2006
Last updated
11/22/2013
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