Provider Demographics
NPI:1386897049
Name:BRUNSON, TWONNETT DEUNDRA (MSW)
Entity type:Individual
Prefix:MISS
First Name:TWONNETT
Middle Name:DEUNDRA
Last Name:BRUNSON
Suffix:
Gender:F
Credentials:MSW
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 2685
Mailing Address - Street 2:
Mailing Address - City:FORT PIERCE
Mailing Address - State:FL
Mailing Address - Zip Code:34954-2685
Mailing Address - Country:US
Mailing Address - Phone:772-489-3608
Mailing Address - Fax:772-489-3608
Practice Address - Street 1:905 N 20TH STREET
Practice Address - Street 2:
Practice Address - City:FORT PIERCE
Practice Address - State:FL
Practice Address - Zip Code:34950
Practice Address - Country:US
Practice Address - Phone:772-489-3608
Practice Address - Fax:772-489-3608
Is Sole Proprietor?:Yes
Enumeration Date:2008-10-28
Last Update Date:2008-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker