Doctor Name: | MS. CHANTEL M BRYANT |
NPI Number: | 1295144392 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | RMHCI, CAP |
License Number: | 5868 |
Business Practice Address: | 463142 State Road 200 Yulee, FL - 320975554 |
Business Phone Number: | 9042258280 |
Business Fax Number: | 9042258232 |
Mailing Address: | 463142 State Road 200, YULEE |
State: | FL |
Postal Code: | 320975554 |
Phone Number: | 9042258280 |
Fax Number: | 9042258232 |
NPI Enumeration Date: | 08/04/2014 |
NPI Last Update Date: | 08/04/2014 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YA0400X |
License Number: | 5868 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | FL |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Addiction (Substance Use Disorder) |
Taxonomy Definition: |