Healthcare Provider Details

I. General information

NPI: 1508498619
Provider Name (Legal Business Name): ALISON PAGE BRYANT LMHC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/06/2020
Last Update Date: 08/07/2023
Certification Date: 08/07/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

475 OSCEOLA ST STE 1200
ALTAMONTE SPRINGS FL
32701-7857
US

IV. Provider business mailing address

2009 MILLINGTON LN
JACKSONVILLE FL
32246-1387
US

V. Phone/Fax

Practice location:
  • Phone: 407-755-6069
  • Fax:
Mailing address:
  • Phone: 386-898-3450
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberMH21763
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: