Provider Demographics
NPI:1396433819
Name:EXCELL, BRONWYN (MSC COUNSELING, APC)
Entity type:Individual
Prefix:MRS
First Name:BRONWYN
Middle Name:
Last Name:EXCELL
Suffix:
Gender:F
Credentials:MSC COUNSELING, APC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:555 SUN VALLEY DR STE M2
Mailing Address - Street 2:
Mailing Address - City:ROSWELL
Mailing Address - State:GA
Mailing Address - Zip Code:30076-5631
Mailing Address - Country:US
Mailing Address - Phone:678-381-1678
Mailing Address - Fax:
Practice Address - Street 1:555 SUN VALLEY DR STE M2
Practice Address - Street 2:
Practice Address - City:ROSWELL
Practice Address - State:GA
Practice Address - Zip Code:30076-5631
Practice Address - Country:US
Practice Address - Phone:678-381-1678
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-04-25
Last Update Date:2023-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Multi-Specialty