Doctor Name: | KRISTEN MARY BRUMLEVE |
NPI Number: | 1003193384 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | MOTR/L |
License Number: | OT11472 |
Business Practice Address: | 785 Grand Ave Ste 208 Carlsbad, CA - 920082371 |
Business Phone Number: | 7607309675 |
Business Fax Number: | 7602958623 |
Mailing Address: | 8875 Costa Verde Blvd Apt 414, SAN DIEGO |
State: | CA |
Postal Code: | 921226655 |
Phone Number: | |
Fax Number: | |
NPI Enumeration Date: | 11/14/2011 |
NPI Last Update Date: | 11/14/2011 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 174400000X |
License Number: | OT11472 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | CA |
Taxonomy Type: | Other Service Providers |
Taxonomy Classification: | Specialist |
Taxonomy Specialization: | |
Taxonomy Definition: | An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. |