Individual
MS. BREANNA ROSE PENNYPACKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
14707 S CHESHIRE ST, BURTON, OH 44021-9601
(440) 887-1100
(440) 887-1103
Mailing address
11176 CLARIDON TROY RD, CHARDON, OH 44024-9469
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
CDCA.175932
OH
101YP2500X
Professional Counselor
C.2406080
OH
Other
Enumeration date
01/15/2024
Last updated
07/08/2024
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