Individual
JACQUELYNE J BRYNER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LSW
Contact information
Practice address
7232 JUSTIN WAY, MENTOR, OH 44060-4881
(440) 578-8200
Mailing address
7232 JUSTIN WAY, MENTOR, OH 44060-4881
(440) 578-8200
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
S.1101110
OH
1041C0700X
Clinical Social Worker
Primary
S.1101110
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0307629
—
OH
Enumeration date
08/14/2018
Last updated
10/31/2021
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