Individual
MR. JOHNNY LEE O'BRYANT II
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CIT 3419 3/19/16
Contact information
Practice address
4255 E BROOKSTOWN DR, BATON ROUGE, LA 70805-4603
(225) 927-0770
(225) 927-0771
Mailing address
4255 E BROOKSTOWN DR, BATON ROUGE, LA 70805-4603
(225) 927-0770
(225) 927-0771
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
CIT 3419
LA
Other
Enumeration date
01/28/2016
Last updated
01/28/2016
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