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General NPI Number Information
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NPI Number | 1467552174
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Entity Type | Individual
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Provider Name | DEBORAH BRUNO LCSW
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Gender | Female
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Dates
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Enumeration Date | 09/23/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 2627 NE 203RD ST SUITE 211
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City | AVENTURA
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State | FL
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Zip | 33180-1900
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Country | US
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Telephone | 305-905-7177
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Fax |
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Provider Business Mailing Address
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Address Line | 3400 NE 192ND ST PH LP10
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City | AVENTURA
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State | FL
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Zip | 33180-2462
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Country | US
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Telephone | 305-905-7177
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Fax | 305-792-0217
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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 | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | SW6832
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License Number State | FL
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