Doctor Name: | TERYN BRUNI |
NPI Number: | 1194131060 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | TLLP., BCBA |
License Number: | 6301015702 |
Business Practice Address: | 301 S Crapo St Ste 100 Mount Pleasant, MI - 488582941 |
Business Phone Number: | 9898171766 |
Business Fax Number: | |
Mailing Address: | 26 Cedarwood Drive, SAULT STE. MARIE |
State: | ONTARIO |
Postal Code: | P6B5G4 |
Phone Number: | 9898171766 |
Fax Number: | |
NPI Enumeration Date: | 07/10/2014 |
NPI Last Update Date: | 07/10/2014 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 390200000X |
License Number: | 6301015702 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | MI |
Taxonomy Type: | Student, Health Care |
Taxonomy Classification: | Student in an Organized Health Care Education/Training Program |
Taxonomy Specialization: | |
Taxonomy Definition: | An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care. |