Provider Demographics
NPI:1275121709
Name:BRUNSON, KENYA P
Entity Type:Individual
Prefix:MS
First Name:KENYA
Middle Name:P
Last Name:BRUNSON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:40 SERINDIPITY CT
Mailing Address - Street 2:
Mailing Address - City:HOPKINS
Mailing Address - State:SC
Mailing Address - Zip Code:29061
Mailing Address - Country:US
Mailing Address - Phone:803-727-0434
Mailing Address - Fax:
Practice Address - Street 1:40 SERINDIPITY CT
Practice Address - Street 2:
Practice Address - City:HOPKINS
Practice Address - State:SC
Practice Address - Zip Code:29061
Practice Address - Country:US
Practice Address - Phone:803-727-0434
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-01-10
Last Update Date:2021-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor