Brustad Kennedy, Laurie Ann

Brustad Kennedy, Laurie Ann is an individual health care provider with primary practice located at 600 Demers Ave Suite 404, Grand Forks ND 58201-4599. She recently has only one registered license in Behavioral Health & Social Service Providers / Clinical, which is considered as her primary health care specialty. Brustad Kennedy, Laurie Ann can be contacted via phone (701) 746-4400.

Contact Information

Primary practice address
600 Demers Ave Suite 404 Grand Forks ND 58201-4599
Phone: (701) 746-4400
Fax: (701) 746-6034
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Clinical 103TC0700X 222 North Dakota

Profile Details

NPI number 1326169921
LBN Legal business name Brustad Kennedy, Laurie Ann
Credentials PH.D.
Entity Individual
Sole proprietor 1 No
Enumeration date Apr 2nd, 2007
Last updated Jul 8th, 2007 - about 18 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 1326169921 NPPES
Other 088174 VALUE OPTIONS
Other BRU21835 VALUE OPTIONS
Other HP1672 VALUE OPTIONS
MEDICAID 11915 VALUE OPTIONS
Other 308J3BR VALUE OPTIONS
Other 308J3BR VALUE OPTIONS
Other 204771047933 VALUE OPTIONS
Other 5721265 VALUE OPTIONS
Other A002 VALUE OPTIONS

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