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1124041280
BRYAN B. PORT
BERKELEY, CA
NPI
1124041280
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
103TC0700X Psychologist, Clinical
(Licence: CA PSY19116)
Enumeration Date
2006-07-26
Last Update Date
2007-07-08
Business Address
-- BRYAN B. PORT Psy.D.
2046 LINCOLN ST # 2
BERKELEY, CA 94709-2018
Phone number: 510-883-1847
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Mailing Address
-- BRYAN B. PORT Psy.D.
2046 LINCOLN ST # 2
BERKELEY, CA 94709-2018
Phone number: 510-883-1847
Copy
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