| NPI | 1023211430 |
|---|---|
| Former Name | CARLY MARIE BRYANT |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 235Z00000X Speech-Language Pathologist, (Licence: FL 524189) |
| Additional Taxonomies | 222Q00000X Developmental Therapist |
| Enumeration Date | 2007-06-06 |
| Last Update Date | 2011-03-07 |