Brundage, Laurel B
Brundage, Laurel B is an individual health care provider with primary practice located at 7300 E Indiana St Ste 103 , Evansville IN 47715-2794. She recently has only one registered license in Behavioral Health & Social Service Providers / Psychologist, which is considered as her primary health care specialty. Brundage, Laurel B can be contacted via phone (812) 401-8008.Contact Information
Primary practice address
7300 E Indiana St Ste 103
Evansville IN 47715-2794
Phone: (812) 401-8008
Fax: (812) 401-8201
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Psychologist | 103T00000X | 00948 | Iowa |
| Behavioral Health & Social Service Providers / Psychologist | 103T00000X | 00435 | Iowa |
| Behavioral Health & Social Service Providers / Psychologist | 103T00000X | 20042407A | Indiana |
Profile Details
| NPI number | 1558359307 |
|---|---|
| LBN Legal business name | Brundage, Laurel B |
| Credentials | PSY.D. |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Oct 6th, 2005 |
| Last updated | Oct 5th, 2015 - about 11 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1558359307 | NPPES |
| Other | IA01K6 | JOHN DEERE HEALTH PLAN | |
| MEDICAID | 0439240 | JOHN DEERE HEALTH PLAN | |
| Other | 34115 | JOHN DEERE HEALTH PLAN |
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