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Individual

BRYTTENNY SHYANNE GAINES

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MSW

Contact information

Practice address
990 ILLINOIS ST, PLYMOUTH, IN 46563-3622
(574) 936-9646
(574) 395-4773
Mailing address
2621 E JEFFERSON ST, WARSAW, IN 46580-3880
(574) 267-7189
(574) 269-4189

Taxonomy

Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary

Other

Enumeration date
02/19/2015
Last updated
02/19/2015
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