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Individual

BRYAN BELLAMY

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man

Contact information

Practice address
3840 HULEN ST, FORT WORTH, TX 76107-7277
(817) 569-4395
Mailing address
3840 HULEN ST, FORT WORTH, TX 76107-7277
(817) 569-4300

Taxonomy

Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
71638
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
360366401
TX
Enumeration date
08/22/2016
Last updated
09/13/2019
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