Individual
LA'TOYA FELICIA BRUNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
110 STEPHANEE LN, RIDGEWAY, SC 29130-9408
(803) 546-6922
(803) 814-9930
Mailing address
110 STEPHANEE LN, RIDGEWAY, SC 29130-9408
(803) 546-6922
(803) 814-9930
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
1-21-53756
—
106E00000X
Assistant Behavior Analyst
—
—
106S00000X
Behavior Technician
—
—
Other
Enumeration date
10/05/2016
Last updated
07/24/2024
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