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General NPI Number Information
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NPI Number | 1033664099
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Entity Type | Organization
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Legal Business Name | TANYA N BRYANT LCSW-C
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Dates
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Enumeration Date | 08/19/2016
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Last Update Date | 09/23/2016
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Provider Practice Location Address
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Address Line | 4 W ROLLING CROSSROADS SUITE 3
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City | CATONSVILLE
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State | MD
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Zip | 21228-6280
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Country | US
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Telephone | 410-977-8271
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Fax | 410-455-5288
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Provider Business Mailing Address
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Address Line | 808 CLIFFEDGE RD
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City | PIKESVILLE
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State | MD
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Zip | 21208-4605
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Country | US
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Telephone | 410-977-8271
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Fax |
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Authorized Official
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Title or Position | THERAPIST / CLINICAL SOCIAL WORKER
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Name | MS. TANYA NICOLE BRYANT
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Credential | LCS
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Telephone | 410-977-8271
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 14381
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License Number State | MD
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