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1003593914
MARY KAY GORDON-BRUNNER
CALDWELL, ID
NPI
1003593914
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
1041C0700X Social Worker, Clinical
(Licence: ID LCSW-33403)
Enumeration Date
2023-07-03
Last Update Date
2023-08-10
Business Address
MARY KAY GORDON-BRUNNER
314 BADIOLA ST
CALDWELL, ID 83605-4389
Phone number: 702-589-4871
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Mailing Address
MARY KAY GORDON-BRUNNER
PO BOX 264
MIDDLETON, ID 83644-0264
Phone number:
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