Individual
MS. BRENDA RUNYON DEERE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MA, LPA, CPLC, CPWLC
Contact information
Practice address
14466 REFLECTION LAKES DR, FORT MYERS, FL 33907-1806
(239) 791-8679
Mailing address
14466 REFLECTION LAKES DR, FORT MYERS, FL 33907-1806
(239) 791-8679
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2251
PSYCHOLOGY LICENSE NUMBER
NC
05
—
6107167
—
NC
Enumeration date
05/25/2006
Last updated
08/21/2012
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