Individual
MR. BRUCE EVERETT OBRENTZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MA, ICAADC
Contact information
Practice address
3995 S COBB DR SE, SMYRNA, GA 30080-6342
(678) 779-7923
Mailing address
3027 RIVERSTONE TRL, ATLANTA, GA 30339-8450
(678) 779-7923
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
EXEMPT
GA
Other
Enumeration date
08/15/2012
Last updated
08/15/2012
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