Provider Information for 1134119282
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Ms. KELLI ERIN BRUNK LCSW
Sex: Female
NPI: 1134119282
Last Updated: 2007-07-08
Certification Date:
Certification Date:
Details
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NPI | 1134119282 | ||||||||
Enumeration Date | 2005-10-28 | ||||||||
NPI Type | NPI-1 Individual | ||||||||
Sole Proprietor | NO | ||||||||
Status | Active | ||||||||
Mailing Address | 4000 NE 168 ST #6-B NORTH MIAMI BEACH, FL 33160-3500 United States Phone: 786-385-6754 | Fax:305-944-6184 | ||||||||
Primary Practice Address | 1031 IVES DAIRY RD STE 228 MIAMI, FL 33179-2538 United States Phone: 786-385-6754 | Fax:305-944-6184 | ||||||||
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