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Individual

DR. JOAN DIANE BRUGMAN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
PSY.D.

Contact information

Practice address
915 TATE BLVD SE STE 186, HICKORY, NC 28602-4042
(828) 449-8563
(828) 323-8348
Mailing address
915 TATE BLVD SE STE 186, HICKORY, NC 28602-4042
(828) 449-8563
(828) 323-8348

Taxonomy

Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
2300
NC
103TC0700X
Clinical Psychologist
2300
NC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0369Q
BLUE CROSS BLUE SHIELD ID
NC
05
1760540306
NC
05
6000447
NC
Enumeration date
12/05/2006
Last updated
07/10/2019
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