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General NPI Number Information
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NPI Number | 1356497044
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Entity Type | Individual
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Provider Name | CORINE BRUNO
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Gender | Female
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Dates
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Enumeration Date | 01/26/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 402 STATE ROUTE 35 N
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City | NEPTUNE
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State | NJ
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Zip | 07753-4604
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Country | US
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Telephone | 732-869-2788
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Fax |
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Provider Business Mailing Address
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Address Line | 296 BROOKFIELD DR
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City | JACKSON
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State | NJ
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Zip | 08527-3874
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State |
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