Individual
MARDELL Z BRUNSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
100 COASTAL VILLAGE DR APT 102, BRUNSWICK, GA 31520-1936
(912) 230-7689
Mailing address
100 COASTAL VILLAGE DR APT 102, BRUNSWICK, GA 31520-1936
(912) 230-7689
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
Other
Enumeration date
12/18/2024
Last updated
12/18/2024
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