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General NPI Number Information
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NPI Number | 1730052812
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Entity Type | Individual
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Provider Name | BETTY W BRYANT
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Gender | Female
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Dates
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Enumeration Date | 09/25/2025
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Last Update Date | 09/25/2025
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Provider Practice Location Address
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Address Line | 80 HUXFORD ST
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City | HOMERVILLE
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State | GA
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Zip | 31634-2356
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Country | US
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Telephone | 912-470-2273
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Fax | 912-470-2630
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Provider Business Mailing Address
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Address Line | 1050 VALDOSTA HWY
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City | HOMERVILLE
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State | GA
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Zip | 31634-9701
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Country | US
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Telephone | 912-487-5211
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Fax | 912-487-4334
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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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 | CSW009782
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License Number State | GA
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