Individual
KEVIN BRYANT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
3251 ROUTE 112, SUITE 9 UNIT2, MEDFORD, NY 11763-1446
(631) 451-6007
(631) 297-8121
Mailing address
3251 ROUTE 112, SUITE 9 UNIT2, MEDFORD, NY 11763-1446
(631) 451-6007
(631) 297-8121
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
20897
NY
Other
Enumeration date
04/27/2007
Last updated
01/24/2014
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