Individual
MR. JOHN KENNETH BRANTLEY JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MS LPC
Contact information
Practice address
1301 SHILOH RD NW STE 450, KENNESAW, GA 30144-7152
(404) 747-3018
Mailing address
1808 WILLOW BRANCH LN NW, KENNESAW, GA 30152-4558
(404) 747-3018
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
03934
GA
Other
Enumeration date
06/15/2020
Last updated
06/15/2020
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