NPI | 1770239584 |
---|---|
Former Name | MELISSA LYNN BRYANT |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: MO 2016028922) |
Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: KS 05677) |
Enumeration Date | 2022-03-02 |
Last Update Date | 2022-03-02 |