| Doctor Name: | NANCY ANN BRUNNER |
| NPI Number: | 1063759892 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | |
| License Number: | 35S100291100 |
| Business Practice Address: | 85 Crescent Ave Passaic, NJ - 070552437 |
| Business Phone Number: | 9739312276 |
| Business Fax Number: | |
| Mailing Address: | 54 Everittstown Rd, FRENCHTOWN |
| State: | NJ |
| Postal Code: | 088251024 |
| Phone Number: | |
| Fax Number: | |
| NPI Enumeration Date: | 01/14/2013 |
| NPI Last Update Date: | 01/14/2013 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 103TC0700X |
| License Number: | 35S100291100 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | NJ |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Psychologist |
| Taxonomy Specialization: | Clinical |
| Taxonomy Definition: | |