Individual
ELLEN BRUNEEL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTR
Contact information
Practice address
53380 CARMICHAEL DR, SOUTH BEND, IN 46635-1567
(574) 247-9441
Mailing address
53380 CARMICHAEL DR, SOUTH BEND, IN 46635-1567
(574) 247-9441
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
31000074A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
31000074A
IPLA
IN
Enumeration date
09/27/2022
Last updated
10/19/2023
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