Individual
JOHNATHAN ANTONIO BRUNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LCAS-A
Contact information
Practice address
3011 NC HIGHWAY 42 W, SUITE G, WILSON, NC 27893
(252) 991-3985
(252) 991-3993
Mailing address
307 BEECH ST, GOLDSBORO, NC 27530-2818
(919) 731-2119
(919) 739-4989
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
—
Other
Enumeration date
06/06/2016
Last updated
08/04/2020
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