Individual
MR. BRENDON DAVIS MANN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
409 S OAKLAND ST, GASTONIA, NC 28052-4312
(704) 874-9005
Mailing address
200 E 2ND AVE STE 300, GASTONIA, NC 28052-4358
(704) 874-1936
(704) 864-7608
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
4927
NC
101YM0800X
Mental Health Counselor
Primary
4927
NC
101YP2500X
Professional Counselor
4927
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
6102757
—
NC
Enumeration date
11/09/2006
Last updated
10/21/2019
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