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NPI Code Detail

MEDICARE: MRS. ANTONIA C BRYANT LMSW/CSW-I

MEDICARE: MRS. ANTONIA C BRYANT LMSW/CSW-I
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1104100000XSocial Worker9923-MNV
21041C0700XClinical Social WorkerIC-2339NV

General Provider Information

NPI Number : 1801448501
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. ANTONIA C BRYANT LMSW/CSW-I
Provider Business Mailing Address
First Line : 2655 E DEER SPRINGS WAY APT 2061
Second Line :
City : NORTH LAS VEGAS
State : NV
Zip : 89086-1464
Country : US
Telephone Number : 323-599-6740
Fax Number :
Provider Business Practice Location Address
First Line : 4485 S BUFFALO DR
Second Line :
City : LAS VEGAS
State : NV
Zip : 89147-5006
Country : US
Telephone Number : 702-888-6300
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/12/2019
Last Update Date : 01/19/2024

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