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Individual

SANDRA BRYANT

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
9231 W FLORISSANT AVE, SAINT LOUIS, MO 63136-1422
(314) 279-4444
Mailing address
9231 W FLORISSANT AVE, SAINT LOUIS, MO 63136-1422
(314) 279-1444

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
7396
MO

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
7396
MO
Enumeration date
10/28/2022
Last updated
10/28/2022
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