Provider Demographics
NPI:1417357765
Name:BRUNO, MICHELLE (CF-SLP)
Entity type:Individual
Prefix:
First Name:MICHELLE
Middle Name:
Last Name:BRUNO
Suffix:
Gender:F
Credentials:CF-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:210 E MAPLE AVE APT D2
Mailing Address - Street 2:
Mailing Address - City:MERCHANTVILLE
Mailing Address - State:NJ
Mailing Address - Zip Code:08109-2659
Mailing Address - Country:US
Mailing Address - Phone:856-701-2251
Mailing Address - Fax:
Practice Address - Street 1:210 E MAPLE AVE APT D2
Practice Address - Street 2:
Practice Address - City:MERCHANTVILLE
Practice Address - State:NJ
Practice Address - Zip Code:08109-2659
Practice Address - Country:US
Practice Address - Phone:856-701-2251
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-08-23
Last Update Date:2014-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist