Individual
BRENDA KROSS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
302 W MAIN ST, FAIRBORN, OH 45324-5037
(937) 281-4673
(937) 318-1120
Mailing address
3103 DIXIE HWY, HAMILTON, OH 45015-1653
(513) 892-4673
(513) 737-1107
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
CS.00000015
OH
101YA0400X
Addiction (Substance Use Disorder) Counselor
LCDC 081183-3
OH
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
LICDC.081183
OH
101YM0800X
Mental Health Counselor
S.0701012
OH
Other
Enumeration date
02/26/2013
Last updated
06/07/2022
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