Individual
CORISSA L BRUNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCPC
Contact information
Practice address
10662 MORNING HARBOR AVE, LAS VEGAS, NV 89129-3254
(702) 524-4639
Mailing address
10662 MORNING HARBOR AVE, LAS VEGAS, NV 89129-3254
(702) 343-5094
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
9264
NE
101YM0800X
Mental Health Counselor
Primary
CP0092
NV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
9264
—
NE
Enumeration date
12/13/2010
Last updated
10/28/2020
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