Individual
LEROY BRYAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1175 GREEN ST SE, CONYERS, GA 30012-5407
(770) 929-1470
Mailing address
2945 ROSEBUD RD APT 521, LOGANVILLE, GA 30052-8961
(706) 528-8053
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
—
—
Other
Enumeration date
03/20/2020
Last updated
03/20/2020
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