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Individual
NANCY BRYANT-WALLIS
Active
Individual
NANCY BRYANT-WALLIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
6459
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
5352
UPIN
CA
Enumeration date
10/21/2008
Last updated
10/21/2008
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