Individual
MS. TERESA LEE BRUNELLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CDPT
Contact information
Practice address
404 W MAIN ST, KELSO, WA 98626-1118
(360) 423-2806
Mailing address
311 W KINGSBURY RD, KELSO, WA 98626-9523
(360) 560-8826
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
60730867
WA
Other
Enumeration date
02/14/2019
Last updated
02/14/2019
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