| Doctor Name: | MARY BRUNE |
| NPI Number: | 1942423322 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | CCC-SLP |
| License Number: | 12094844 |
| Business Practice Address: | 402 E Lincoln Ave Owensville, MO - 650661445 |
| Business Phone Number: | 5734372177 |
| Business Fax Number: | 5734375808 |
| Mailing Address: | 7992 Beemont Rd, GERALD |
| State: | MO |
| Postal Code: | 630371102 |
| Phone Number: | 5737643321 |
| Fax Number: | |
| NPI Enumeration Date: | 04/11/2007 |
| NPI Last Update Date: | 09/27/2013 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 235Z00000X |
| License Number: | 12094844 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | MO |
| Taxonomy Type: | Speech, Language and Hearing Service Providers |
| Taxonomy Classification: | Speech-Language Pathologist |
| Taxonomy Specialization: | |
| Taxonomy Definition: | A speech pathologist is a person qualified by a master |