Individual
ALEX BRUNING
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
12918 63RD AVE N, MAPLE GROVE, MN 55369-6001
(763) 210-9983
Mailing address
12918 63RD AVE N, MAPLE GROVE, MN 55369-6001
(763) 210-9983
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
306455
MN
101YM0800X
Mental Health Counselor
Primary
4651
MN
Other
Enumeration date
11/05/2024
Last updated
11/05/2024
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