Individual
BRIAN GENNETT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LCDC II
Contact information
Practice address
6434 E MAIN ST, 201, REYNOLDSBURG, OH 43068-7300
(614) 762-2847
(614) 762-2984
Mailing address
6434 E MAIN ST, 201, REYNOLDSBURG, OH 43068-7300
(614) 762-2847
(614) 762-2984
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
141201
OH
Other
Enumeration date
06/27/2016
Last updated
06/27/2016
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