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Individual
SANDRA O BRYANT
Active
Individual
SANDRA O BRYANT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPC,RN
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
0701002573
VA
106H00000X
Marriage & Family Therapist
0717000669
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
004945441
—
VA
01
—
243077
ANTHEM
VA
Enumeration date
09/26/2006
Last updated
09/12/2012
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