Individual
MATICIA BRUNSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
204 E DOGWOOD DR, MULLINS, SC 29574-2112
(843) 430-2502
Mailing address
204 E DOGWOOD DR, MULLINS, SC 29574-2112
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
—
—
101YP1600X
Pastoral Counselor
Primary
—
—
104100000X
Social Worker
—
—
Other
Enumeration date
02/01/2016
Last updated
02/01/2016
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