Individual
KIMBERLY N WYMAN BRYANT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
BMS
Contact information
Practice address
1100 W 21ST STREET, CLOVIS, NM 88101
(575) 769-2345
(575) 769-9013
Mailing address
1100 W 21ST STREET, CLOVIS, NM 88101
(575) 769-2345
(575) 769-9013
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
CTB-2022-0932
NM
101Y00000X
Counselor
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
69732299
—
NM
Enumeration date
05/26/2010
Last updated
12/28/2022
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