Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103K00000X | Behavior Analyst | 014 | SD |
NPI | 1003370495 |
---|---|
Provider Name | Amber Bruns |
First Address | Sioux Falls, SD 57106-5146 |
Second Address | Montevideo, MN 56265 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 30/01/2019 |
Last Update Date | 02/10/2019 |