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Individual

JESSICA BRUNO

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
1213 W MOREHEAD ST SUITE 500, CHARLOTTE, NC 28208-2107
(704) 851-5233
Mailing address
1213 W MOREHEAD ST STE 500, CHARLOTTE, NC 28208-5581
(704) 704-8242

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
011062
NY
101YM0800X
Mental Health Counselor
Primary
16143
NC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
01420795
NY
Enumeration date
12/09/2019
Last updated
04/28/2021
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