Provider Demographics
NPI:1225372204
Name:BRUNNER, ALANA JO (LCPC, NCC)
Entity type:Individual
Prefix:
First Name:ALANA
Middle Name:JO
Last Name:BRUNNER
Suffix:
Gender:F
Credentials:LCPC, NCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7013 W HUMMEL DR
Mailing Address - Street 2:
Mailing Address - City:BOISE
Mailing Address - State:ID
Mailing Address - Zip Code:83709-1939
Mailing Address - Country:US
Mailing Address - Phone:208-367-6229
Mailing Address - Fax:208-376-0285
Practice Address - Street 1:131 N ALLUMBAUGH ST
Practice Address - Street 2:
Practice Address - City:BOISE
Practice Address - State:ID
Practice Address - Zip Code:83704-9204
Practice Address - Country:US
Practice Address - Phone:208-367-6229
Practice Address - Fax:208-376-0285
Is Sole Proprietor?:No
Enumeration Date:2012-11-15
Last Update Date:2012-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IDLCPC-4699101YP2500X
NCC-275357101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional