Individual
BRETT KNOTT JR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LICDC-CS, LPC
Contact information
Practice address
12888 GREY ST, LOGAN, OH 43138-9638
(740) 517-9272
Mailing address
10102 GRASS RUN, NEW MARSHFIELD, OH 45766-9727
(740) 517-9272
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
111-060-CS
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0200008
—
OH
Enumeration date
11/14/2013
Last updated
08/15/2016
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