Individual
BRIAN CHARLES EVERITT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LCSW
Contact information
Practice address
57590 LEAVENWORTH, MCCONNELL AFB, KS 67221-3506
(316) 759-6684
Mailing address
4881 SUGAR MAPLE DR, WRIGHT PATTERSON AFB, OH 45433-5529
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
2001015521
MO
Other
Enumeration date
09/29/2005
Last updated
09/20/2022
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