Individual
LISA IVEY BRYANT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MS CCCSLP
Contact information
Practice address
100 HICKORY ST, GREENVILLE, NC 27858-1674
(252) 412-5509
Mailing address
1511 WESTPOINTE DR, GREENVILLE, NC 27834-8421
(252) 412-5509
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
2660
NC
Other
Enumeration date
02/02/2020
Last updated
02/02/2020
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