Doctor Name: | MR. DAVID RONALD BRYANT |
NPI Number: | 1467462960 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | LPC |
License Number: | 0701003166 |
Business Practice Address: | 200 8th St Radford, VA - 24141 |
Business Phone Number: | 5407310838 |
Business Fax Number: | 5407313375 |
Mailing Address: | 200 8th St, RADFORD |
State: | VA |
Postal Code: | 24141 |
Phone Number: | 5407310838 |
Fax Number: | 5407313375 |
NPI Enumeration Date: | 08/08/2006 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YP2500X |
License Number: | 0701003166 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | VA |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Professional |
Taxonomy Definition: |