Individual
BRYAN KEVIN GANNON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LCSW
Contact information
Practice address
7290 W 14TH AVE, LAKEWOOD, CO 80214-4725
(303) 232-8047
Mailing address
4851 INDEPENDENCE ST, SUITE 200, WHEAT RIDGE, CO 80033-6715
(410) 432-5400
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
551
CO
Other
Enumeration date
01/22/2007
Last updated
07/08/2007
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