Individual
ALLISON JEANETTE BRUNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MA, BCBA, LBA
Contact information
Practice address
611 N FOUNTAIN ST, CAPE GIRARDEAU, MO 63701-7244
(573) 986-4985
Mailing address
611 N FOUNTAIN ST, CAPE GIRARDEAU, MO 63701-7244
(573) 986-4985
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
2018033386
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2018033386
—
MO
Enumeration date
02/08/2019
Last updated
02/08/2019
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