Individual
BRUENETTER ELLIS WRIGHT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ADDICTION COUNSELOR
Contact information
Practice address
1957 LAKESIDE PKWY STE 510, TUCKER, GA 30084-5859
(404) 289-0313
(404) 289-0314
Mailing address
PO BOX 479, AVONDALE ESTATES, GA 30002-0479
(404) 289-0313
(404) 289-0314
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
20245062T52
GA
Other
Enumeration date
03/31/2025
Last updated
03/31/2025
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