| NPI | 1477208510 |
|---|---|
| Doing Business As | LARRY BRUNSON LLC |
| Entity Type | Organization |
| Authorized Contact | LARRY BRUNSON Owner 317-985-3119 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health |
| Enumeration Date | 2022-02-17 |
| Last Update Date | 2022-02-17 |