Individual
SUSAN M BRUNDAGE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LLP
Contact information
Practice address
694 W CHICAGO RD, COLDWATER, MI 49036-8405
(517) 279-8866
(517) 279-8866
Mailing address
PO BOX 2588, PORTAGE, MI 49081-2588
(269) 373-8878
(269) 373-4720
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
6301010897
MI
Other
Enumeration date
02/06/2007
Last updated
07/08/2007
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