Individual
GINA MARIE BRUNSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RBT
Contact information
Practice address
538 APRICOT ST, STAFFORD, VA 22554-2555
(540) 623-4127
Mailing address
26 FERGUSON DR APT 203, STAFFORD, VA 22554-7153
(404) 754-9663
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
10/24/2018
Last updated
10/24/2018
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