Provider Demographics
NPI:1700071339
Name:BRUNWASSER, STEVEN MICHAEL (PHD)
Entity Type:Individual
Prefix:DR
First Name:STEVEN
Middle Name:MICHAEL
Last Name:BRUNWASSER
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:230 APPLETON PL
Mailing Address - Street 2:VANDERBILT UNIVERSITY, PEABODY COLLEGE #552,
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37203-5721
Mailing Address - Country:US
Mailing Address - Phone:215-870-4595
Mailing Address - Fax:
Practice Address - Street 1:230 APPLETON PL
Practice Address - Street 2:VANDERBILT UNIVERSITY, PEABODY COLLEGE #552,
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37203-5721
Practice Address - Country:US
Practice Address - Phone:215-870-4595
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-09-06
Last Update Date:2015-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN3236103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical