Individual
MS. KELLY O'BRYANT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LMSW
Contact information
Practice address
501 MIZE ST, LA FAYETTE, GA 30728-3346
(706) 956-5526
Mailing address
PO BOX 1027, LA FAYETTE, GA 30728-1027
(706) 956-5526
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
MSW007078
GA
Other
Enumeration date
03/31/2016
Last updated
03/31/2016
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