MEDICARE: DOLORES BRYANT

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy
1	171M00000X	Case Manager/Care Coordinator
2	3747P1801X	Personal Care Attendant
3	106S00000X	Behavior Technician

General Provider Information

NPI Number	:	1174189955
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DOLORES BRYANT

Provider Business Mailing Address
First Line	:	1818 NEW YORK AVE NE STE 115
Second Line	:
City	:	WASHINGTON
State	:	DC
Zip	:	20002-1851
Country	:	US
Telephone Number	:	301-799-4795
Fax Number	:

Provider Business Practice Location Address
First Line	:	1100 MISSISSIPPI AVE SE APT 121
Second Line	:
City	:	WASHINGTON
State	:	DC
Zip	:	20032-4448
Country	:	US
Telephone Number	:	202-621-4419
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/16/2019
Last Update Date	:	01/14/2026

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Directions to “ DOLORES BRYANT ” Practice Location

Language	Start Address	Practice Location

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