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:
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Health care specialties

SpecialtyCodeLicense #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.

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Identifiers

StateTypeNumberIssuer
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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