Provider Demographics
NPI:1407161011
Name:BRUNN, STEPHANIE
Entity Type:Individual
Prefix:
First Name:STEPHANIE
Middle Name:
Last Name:BRUNN
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 1:500 ROUTE 909
Mailing Address - Street 2:HEALTHCARE CENTER
Mailing Address - City:VERONA
Mailing Address - State:PA
Mailing Address - Zip Code:15147-3831
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:500 ROUTE 909
Practice Address - Street 2:HEALTHCARE CENTER
Practice Address - City:VERONA
Practice Address - State:PA
Practice Address - Zip Code:15147-3831
Practice Address - Country:US
Practice Address - Phone:412-826-5990
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-08-09
Last Update Date:2021-05-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASL004300L235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist