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Individual

JOHN BRYANT

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
MS LMFT LCAC

Contact information

Practice address
10347 OREILLY DR, RENSSELAER, IN 47978-9565
(219) 866-2478
Mailing address
10347 OREILLY DR, RENSSELAER, IN 47978-9565
(219) 866-2478

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
8700965A
IN
106H00000X
Marriage & Family Therapist
Primary
35001686A
IN

Other

Enumeration date
06/05/2014
Last updated
06/05/2014
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