Healthcare Provider Details

I. General information

NPI: 1790697498
Provider Name (Legal Business Name): LAUREN BRYANT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/18/2026
Last Update Date: 09/18/2026
Certification Date: 09/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1034 MONTICELLO PL
GALLATIN TN
37066-4853
US

IV. Provider business mailing address

1034 MONTICELLO PL
GALLATIN TN
37066-4853
US

V. Phone/Fax

Practice location:
  • Phone: 615-426-7394
  • Fax:
Mailing address:
  • Phone: 615-426-7394
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TS0200X
TaxonomySchool Psychologist
License Number000572911
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: