Individual
BRENT J WING
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
CT,CDA
Contact information
Practice address
102 DAWN LN, WAVERLY, OH 45690-9695
(740) 947-7783
Mailing address
4449 STATE ROUTE 159, CHILLICOTHE, OH 45601-8620
(740) 772-7886
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
CDCA.130002
OH
Other
Enumeration date
07/26/2013
Last updated
07/26/2013
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