Individual
ROBERT BRUNNER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MSW LCSW
Contact information
Practice address
1020 LAKESHORE DR, RICE LAKE, WI 54868
(715) 236-8100
Mailing address
1000 N OAK AVE, MARSHFIELD, WI 54449-5777
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
1618
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
39658400
—
WI
Enumeration date
08/24/2006
Last updated
07/08/2007
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