Provider Demographics
NPI:1477939148
Name:BRUFLODT, DENIS (LMHC-TMP)
Entity Type:Individual
Prefix:
First Name:DENIS
Middle Name:
Last Name:BRUFLODT
Suffix:
Gender:M
Credentials:LMHC-TMP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 582
Mailing Address - Street 2:
Mailing Address - City:PARKERSBURG
Mailing Address - State:IA
Mailing Address - Zip Code:50665-0582
Mailing Address - Country:US
Mailing Address - Phone:319-346-1216
Mailing Address - Fax:319-346-1217
Practice Address - Street 1:505 COATES ST
Practice Address - Street 2:
Practice Address - City:PARKERSBURG
Practice Address - State:IA
Practice Address - Zip Code:50665-7733
Practice Address - Country:US
Practice Address - Phone:319-346-1216
Practice Address - Fax:319-346-1217
Is Sole Proprietor?:No
Enumeration Date:2015-08-05
Last Update Date:2015-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA077619101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health