Doctor Name: | TRACEY RENEE BRYANT |
NPI Number: | 1053629212 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | |
License Number: | |
Business Practice Address: | 331 S 3rd St Bardstown, KY - 400041032 |
Business Phone Number: | 5023489206 |
Business Fax Number: | 5023486485 |
Mailing Address: | 201 S 5th St, BARDSTOWN |
State: | KY |
Postal Code: | 400041142 |
Phone Number: | 5023486309 |
Fax Number: | 5023482793 |
NPI Enumeration Date: | 09/21/2010 |
NPI Last Update Date: | 04/28/2016 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101Y00000X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | |
Taxonomy Definition: | A provider who is trained and educated in the performance of behavior health services through interpersonal communications and analysis. Training and education at the specialty level usually requires a master |