Healthcare Provider Details

I. General information

NPI: 1093983116
Provider Name (Legal Business Name): CHRISTINE MICHELLE BRUNET LMSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/11/2008
Last Update Date: 02/11/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

90 E MAIN ST
WASHINGTONVILLE NY
10992-2302
US

IV. Provider business mailing address

26 WILLIAMS AVE
NEWBURGH NY
12550-7226
US

V. Phone/Fax

Practice location:
  • Phone: 845-541-3318
  • Fax:
Mailing address:
  • Phone: 845-568-5192
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number071306-1
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: