Individual
BRYAN B MANDERFIELD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PCC-S
Contact information
Practice address
311 ALBERT SABIN WAY, CINCINNATI, OH 45229-2838
(513) 558-5801
Mailing address
311 ALBERT SABIN WAY, CINCINNATI, OH 45229-2838
(513) 558-5801
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
E.0500983-SUPV
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0207876
—
OH
Enumeration date
04/11/2016
Last updated
11/29/2023
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