| Doctor Name: | DR. BRIAN JERMOE VAN BRUNT |
| NPI Number: | 1205047669 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | EDD |
| License Number: | 306 |
| Business Practice Address: | 24 Bridge St Henniker, NH - 032423202 |
| Business Phone Number: | 6034913215 |
| Business Fax Number: | |
| Mailing Address: | Po Box 391, HENNIKER |
| State: | NH |
| Postal Code: | 032420391 |
| Phone Number: | 6034913215 |
| Fax Number: | |
| NPI Enumeration Date: | 05/25/2007 |
| NPI Last Update Date: | 07/08/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YM0800X |
| License Number: | 306 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | NH |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Mental Health |
| Taxonomy Definition: | |