Provider Demographics
NPI:1043571227
Name:BRUENING, CATHERINE ANN
Entity Type:Individual
Prefix:MRS
First Name:CATHERINE
Middle Name:ANN
Last Name:BRUENING
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2040 E COUNTY ROAD 50
Mailing Address - Street 2:
Mailing Address - City:BOWEN
Mailing Address - State:IL
Mailing Address - Zip Code:62316-2208
Mailing Address - Country:US
Mailing Address - Phone:217-617-6769
Mailing Address - Fax:
Practice Address - Street 1:2040 E COUNTY ROAD 50
Practice Address - Street 2:
Practice Address - City:BOWEN
Practice Address - State:IL
Practice Address - Zip Code:62316-2208
Practice Address - Country:US
Practice Address - Phone:217-617-6769
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-06-04
Last Update Date:2012-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes222Q00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersDevelopmental Therapist