Individual
BRENDA BRUNSTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3303 NOBLE VINES DR # 171, BUFORD, GA 30519-6131
(229) 561-0772
Mailing address
5856 UNION RD, HAHIRA, GA 31632-4219
(229) 561-0772
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
LPC013001
GA
Other
Enumeration date
02/09/2022
Last updated
04/11/2024
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