Provider Demographics
NPI:1366101750
Name:WEISNER, BRYAN COLLIN
Entity type:Individual
Prefix:
First Name:BRYAN
Middle Name:COLLIN
Last Name:WEISNER
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7002 TREELINE DR
Mailing Address - Street 2:
Mailing Address - City:HARRISON
Mailing Address - State:TN
Mailing Address - Zip Code:37341-9564
Mailing Address - Country:US
Mailing Address - Phone:615-559-3771
Mailing Address - Fax:
Practice Address - Street 1:7002 TREELINE DR
Practice Address - Street 2:
Practice Address - City:HARRISON
Practice Address - State:TN
Practice Address - Zip Code:37341-9564
Practice Address - Country:US
Practice Address - Phone:615-559-3771
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-12-13
Last Update Date:2021-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)