Provider Demographics
NPI:1154610806
Name:BRUNSON, VALERIE MICHELLE (MS, BCBA)
Entity type:Individual
Prefix:MRS
First Name:VALERIE
Middle Name:MICHELLE
Last Name:BRUNSON
Suffix:
Gender:F
Credentials:MS, BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 780639
Mailing Address - Street 2:
Mailing Address - City:TALLASSEE
Mailing Address - State:AL
Mailing Address - Zip Code:36078-0007
Mailing Address - Country:US
Mailing Address - Phone:334-225-0025
Mailing Address - Fax:334-252-1282
Practice Address - Street 1:101 S DUBOIS ST
Practice Address - Street 2:
Practice Address - City:TALLASSEE
Practice Address - State:AL
Practice Address - Zip Code:36078-1405
Practice Address - Country:US
Practice Address - Phone:334-225-0025
Practice Address - Fax:334-252-1282
Is Sole Proprietor?:No
Enumeration Date:2011-04-04
Last Update Date:2011-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1-05-2150103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst