Provider Demographics
NPI:1043650690
Name:BRUNO, MARIE A (BA)
Entity Type:Individual
Prefix:MISS
First Name:MARIE
Middle Name:A
Last Name:BRUNO
Suffix:
Gender:F
Credentials:BA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1900B RALPH AVE
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11234-5302
Mailing Address - Country:US
Mailing Address - Phone:718-253-1366
Mailing Address - Fax:
Practice Address - Street 1:1900B RALPH AVE
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11234-5302
Practice Address - Country:US
Practice Address - Phone:718-253-1366
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-06-27
Last Update Date:2013-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health