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Individual

MS. ANN LAKE BRYANT

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
M.A.

Contact information

Practice address
6918 WINDSOR AVE, BERWYN, IL 60402-3334
(708) 745-5277
(708) 795-4834
Mailing address
148 N HUMPHREY AVE, APT C1, OAK PARK, IL 60302-2540
(708) 948-7193

Taxonomy

Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary

Other

Enumeration date
10/01/2009
Last updated
10/01/2009
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