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Individual

ALICIA MARIE JOHNSON BRYANT

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
LCSW

Contact information

Practice address
6530 CAPRICORN DR, INDIANAPOLIS, IN 46237-4833
(317) 373-0749
Mailing address
6530 CAPRICORN DR, INDIANAPOLIS, IN 46237-4833
(317) 373-0749

Taxonomy

Speciality
Code
Description
License number
State
104100000X
Social Worker
MSW005753
GA
1041C0700X
Clinical Social Worker
Primary
34008948A
IN
1041C0700X
Clinical Social Worker
CSW007058
GA

Other

Enumeration date
03/14/2016
Last updated
01/09/2024
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