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General NPI Number Information
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NPI Number | 1922533694
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Entity Type | Individual
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Provider Name | DIANA BRYANT LMFTA
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Gender | Female
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Dates
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Enumeration Date | 05/01/2017
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Last Update Date | 05/09/2017
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Provider Practice Location Address
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Address Line | 153 JEFFERSON CHURCH RD STE E
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City | KING
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State | NC
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Zip | 27021-8605
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Country | US
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Telephone | 336-448-4145
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Fax |
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Provider Business Mailing Address
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Address Line | 1870 OSCAR FRYE RD
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City | PINNACLE
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State | NC
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Zip | 27043-8269
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Country | US
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Telephone | 336-408-9526
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Fax |
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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 | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | 10097A
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License Number State | NC
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