Individual
DOROTHY ANGELA BRUNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.S., CCC-SLP
Contact information
Practice address
2500 N STATE ST, DEPT OF OTOLARYNGOLOGY, JACKSON, MS 39216-4500
(601) 984-4555
Mailing address
DEPT #2130, PO BOX 11407, BIRMINGHAM, AL 35246-2130
(601) 925-6805
(601) 926-4971
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
S2429
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00981345
—
MS
Enumeration date
10/14/2008
Last updated
01/07/2014
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