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Individual

AMIE DE'SHANA BRUNSON

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
LMSW

Contact information

Practice address
316 BEAUMONT DR, LEXINGTON, SC 29072-8848
(803) 315-7565
Mailing address
316 BEAUMONT DR, LEXINGTON, SC 29072-8848
(803) 315-7565

Taxonomy

Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
10065
SC

Other

Enumeration date
02/10/2020
Last updated
02/10/2020
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