Individual
JESSICA JANEL BRUNI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
3565 S STATE ROAD 13, WABASH, IN 46992-9162
(260) 563-8453
Mailing address
3565 S STATE ROAD 13, WABASH, IN 46992-9162
(260) 563-8453
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
—
—
104100000X
Social Worker
—
—
1041C0700X
Clinical Social Worker
Primary
34010161A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
300072386
—
IN
Enumeration date
08/16/2019
Last updated
12/17/2024
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