| NPI | 1831717636 |
|---|---|
| Former Name | AMANDA ELLEN BRYANT |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner Psychiatric/Mental Health (Licence: AZ 242549) |
| Enumeration Date | 2020-07-08 |
| Last Update Date | 2020-07-08 |