Individual
MRS. KELLI BRUNSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MS CCC-SLP
Contact information
Practice address
3160 W MAIN ST, SUITE 1, DOTHAN, AL 36305-1185
(334) 699-2348
(334) 699-2727
Mailing address
3160 W MAIN ST, SUITE 1, DOTHAN, AL 36305-1185
(334) 699-2348
(334) 699-2727
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
1020
AL
Other
Enumeration date
08/13/2010
Last updated
08/13/2010
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