Organization
REPRESENT WELLNESS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MELANIE SHARONDA BRUNNER LICSW (OWNER/LEAD THERAPIST)
(205) 861-4144
Entity
Organization
Contact information
Practice address
611 28TH AVE, TUSCALOOSA, AL 35401-1715
(205) 409-8248
Mailing address
3920 WATERMELON RD APT B, NORTHPORT, AL 35473-5183
(205) 861-4144
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
—
—
Other
Enumeration date
03/24/2021
Last updated
04/15/2021
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