Individual
CYNTHIA BRYAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
BSW, RSW, LAC
Contact information
Practice address
1705 FELICIA AVE, TALLULAH, LA 71282-8203
(318) 574-1232
(318) 574-8646
Mailing address
1705 FELICIA AVE, TALLULAH, LA 71282-8203
(318) 574-1232
(318) 574-8646
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
710
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1033582309
—
LA
Enumeration date
11/09/2015
Last updated
03/17/2018
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