Antonia Brunnert, CSW
Individual provider Active NPI Counselor · Taos, NM
NPI 1275959603 · NPPES record last updated Jun 24, 2015
Key facts
- NPI
- 1275959603
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Counselor 101Y00000X
- Practice address
- 1509 Paseo del Pueblo Sur
Taos, NM 87571-5922 - Phone
- (505) 758-7263
- NPI assigned
- Mar 10, 2014
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Counselor | 101Y00000X | Yes |
Addresses
Primary practice location
1509 Paseo del Pueblo Sur
Taos, NM 87571-5922
Mailing address
2551 Coors Blvd NW
Albuquerque, NM 87120-1213
Phone (505) 338-3320
Other providers in Taos, NM
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 24, 2015. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.