Individual
MS. SHARON ALISSA JOHNSON BRUNSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MA CCC/SLP
Contact information
Practice address
397 BROOKDALE DR, ORANGEBURG, SC 29115-3907
(803) 707-6962
(803) 937-5642
Mailing address
397 BROOKDALE DR, ORANGEBURG, SC 29115-3907
(803) 707-6962
(803) 937-5642
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
2255
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
SA093
—
SC
Enumeration date
03/03/2008
Last updated
09/13/2016
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