Provider Demographics
NPI:1346549870
Name:BRYNER, ZEBULIN JACOB (LSW)
Entity Type:Individual
Prefix:
First Name:ZEBULIN
Middle Name:JACOB
Last Name:BRYNER
Suffix:
Gender:M
Credentials:LSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8638 ROUTE 104
Mailing Address - Street 2:SUITE 10
Mailing Address - City:MOUNT PLEASANT MILLA
Mailing Address - State:PA
Mailing Address - Zip Code:17853
Mailing Address - Country:US
Mailing Address - Phone:717-856-0220
Mailing Address - Fax:
Practice Address - Street 1:8638 ROUTE 104 STE 10
Practice Address - Street 2:
Practice Address - City:MOUNT PLEASANT MILLS
Practice Address - State:PA
Practice Address - Zip Code:17853-8753
Practice Address - Country:US
Practice Address - Phone:717-856-0220
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-03-23
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASW134757104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker