| Doctor Name: | CYNTHIA BRYAN |
| NPI Number: | 1033582309 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | |
| License Number: | 710 |
| Business Practice Address: | 308 Nasif St Jonesville, LA - 713432138 |
| Business Phone Number: | 3183396203 |
| Business Fax Number: | |
| Mailing Address: | 1800 Community, CLINTON |
| State: | MO |
| Postal Code: | 647358804 |
| Phone Number: | 6608908186 |
| Fax Number: | |
| NPI Enumeration Date: | 11/09/2015 |
| NPI Last Update Date: | 11/09/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YA0400X |
| License Number: | 710 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | LA |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Addiction (Substance Use Disorder) |
| Taxonomy Definition: | |