Individual
PAMELA BRYAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
US HWY 491 NORTH, SHIPROCK, NM 87420
(505) 368-7301
Mailing address
PO BOX 160, SHIPROCK, NM 87420-0160
(505) 368-7301
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
M-10723
NM
1041C0700X
Clinical Social Worker
X-10377
NM
Other
Enumeration date
04/20/2018
Last updated
10/31/2019
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