Individual
MR. CORNELL J. BRUNSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MS, LCADC
Contact information
Practice address
2630 E CHESTNUT AVE, SUITE D-4, VINELAND, NJ 08361-8400
(856) 776-6649
(856) 696-4799
Mailing address
1066 NEW PEAR ST, VINELAND, NJ 08360-3940
(856) 776-6649
(856) 696-4799
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
37LC00095400
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
11767849
AETNA
NJ
Enumeration date
11/05/2007
Last updated
11/07/2007
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