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NPI Code Detail

MEDICARE: MS. ESTHER KLARA BRUNNER-KISH LCSW-C

MEDICARE: MS. ESTHER KLARA BRUNNER-KISH LCSW-C
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
11041C0700XClinical Social Worker08448MD

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1012745OTHERMDPROVIDER TAXONOMY
2110309OTHERMDPROVIDER TAXONOMY
31234MAMIOTHERMDPROVIDER TAXONOMY

General Provider Information

NPI Number : 1922337401
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. ESTHER KLARA BRUNNER-KISH LCSW-C
Provider Business Mailing Address
First Line : 4100 MITSCHER CT
Second Line :
City : KENSINGTON
State : MD
Zip : 20895-1307
Country : US
Telephone Number : 301-942-5168
Fax Number :
Provider Business Practice Location Address
First Line : 4100 MITSCHER CT
Second Line :
City : KENSINGTON
State : MD
Zip : 20895-1307
Country : US
Telephone Number : 301-942-5168
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/14/2009
Last Update Date : 12/14/2009

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