Provider Information for 1083385819
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Mr. HERMAN BUNN MA, LPC
Sex: Male
NPI: 1083385819
Last Updated: 2021-09-22
Certification Date: 2021-09-22
Certification Date: 2021-09-22
Details
| Name | Value | ||||||||
|---|---|---|---|---|---|---|---|---|---|
| NPI | 1083385819 | ||||||||
| Enumeration Date | 2021-09-22 | ||||||||
| NPI Type | NPI-1 Individual | ||||||||
| Sole Proprietor | YES | ||||||||
| Status | Active | ||||||||
| Mailing Address | 42 CROOKED BRANCH DR CLAYTON, GA 30525-8001 United States Phone: 706-782-3671 | Fax:706-782-3671 | ||||||||
| Primary Practice Address | 42 CROOKED BRANCH DR CLAYTON, GA 30525-8001 United States Phone: 706-782-3671 | Fax:706-782-3671 | ||||||||
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