Individual
MS. MIRACLE ANNZETTE BRYANT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1104 HANLEY RD, OCEAN SPRINGS, MS 39564-3118
(718) 215-5311
(718) 865-5165
Mailing address
1104 HANLEY RD, OCEAN SPRINGS, MS 39564-3118
(718) 215-5311
(718) 865-5165
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
RBT-24-363370
MS
Other
Enumeration date
07/23/2024
Last updated
07/23/2024
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