Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101Y00000X | Counselor | LPCC 1669 | CA |
N | 101YA0400X | Addiction Counselor (Substance Use Disorder) | RA010680315 | CA |
N | 101YM0800X | Mental Health Counselor | 006110 | NY |
N | 101YP2500X | Professional Counselor | LPCC 1669 | CA |
NPI | 1003068131 |
---|---|
Provider Name | Donna Marie Brunetti |
First Address | Lake Forest, CA 92630-8442 |
Second Address | Lake Forest, CA 92630-8442 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 21/10/2008 |
Last Update Date | 02/08/2018 |