Provider Demographics
NPI:1417382516
Name:BRUINGTON, BARBARA DENISE
Entity Type:Individual
Prefix:
First Name:BARBARA
Middle Name:DENISE
Last Name:BRUINGTON
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 1:9 SOFTWOOD LN
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA
Mailing Address - State:SC
Mailing Address - Zip Code:29229-8019
Mailing Address - Country:US
Mailing Address - Phone:803-479-8648
Mailing Address - Fax:
Practice Address - Street 1:9 SOFTWOOD LN
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:SC
Practice Address - Zip Code:29229-8019
Practice Address - Country:US
Practice Address - Phone:803-479-8648
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-09-08
Last Update Date:2014-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional