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Individual

MS. JUDIANN SUCHOMEL BRYANT

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
LPC, CH,CACII, LAT

Contact information

Practice address
2526 SEYMOUR AVE, CHEYENNE, WY 82001
(307) 634-9653
Mailing address
510 W 29TH ST, CHEYENNE, WY 82001-2760
(307) 426-4728

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
.ACB 0007872
CO
101YA0400X
Addiction (Substance Use Disorder) Counselor
ACD.0000669
CO
101YA0400X
Addiction (Substance Use Disorder) Counselor
LAT-387
WY
101YM0800X
Mental Health Counselor
0011665
CO
101YP2500X
Professional Counselor
Primary
LPC-1806
WY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
12561688
CAQH
NC
Enumeration date
08/10/2009
Last updated
09/17/2019
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