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Individual

ANTIONETTE MONDAY BRYANT

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
6171 W. CHARLESTON BOULEVARD, BUILDING 10, LAS VEGAS, NV 89146
(702) 486-7865
Mailing address
6171 W CHARLESTON BLVD, BUILDING 10, LAS VEGAS, NV 89146-1126
(702) 486-7865

Taxonomy

Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
225400000X
Rehabilitation Practitioner

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
225400000X
NV
Enumeration date
01/10/2012
Last updated
10/10/2016
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