Individual
BREUNISTY MYREAL LEE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1992 FLORIDA AVE SW, DENHAM SPRINGS, LA 70726-4971
Mailing address
1992 FLORIDA AVE, DENHAM SPRING, LA 70726
(225) 304-6764
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
Other
Enumeration date
06/16/2025
Last updated
06/16/2025
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