Provider Demographics
NPI:1225862436
Name:BRUNS, ALEXANDRA (LAPC)
Entity type:Individual
Prefix:
First Name:ALEXANDRA
Middle Name:
Last Name:BRUNS
Suffix:
Gender:F
Credentials:LAPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3485 MCEVER RD STE 101
Mailing Address - Street 2:
Mailing Address - City:GAINESVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30504-5542
Mailing Address - Country:US
Mailing Address - Phone:979-743-6014
Mailing Address - Fax:
Practice Address - Street 1:3485 MCEVER RD STE 101
Practice Address - Street 2:
Practice Address - City:GAINESVILLE
Practice Address - State:GA
Practice Address - Zip Code:30504-5542
Practice Address - Country:US
Practice Address - Phone:979-743-6014
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-08-29
Last Update Date:2024-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAAPC009725101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional