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Individual

ANTONE YOHANN BRUMMUND

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MS, LISAC

Contact information

Practice address
3505 WESTERN AVE STE A, KINGMAN, AZ 86409-3074
(928) 757-8111
Mailing address
1743 SYCAMORE AVE, KINGMAN, AZ 86409-0927
(928) 757-8111

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
LISAC-11438
AZ

Other

Enumeration date
01/16/2009
Last updated
11/04/2014
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