Organization
MARLO BRYANT, LMHC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARLO DESHAWN BRYANT LMHC (THERAPIST)
(813) 309-7881
Entity
Organization
Contact information
Practice address
3903 NORTHDALE BLVD STE 100E, TAMPA, FL 33624-1862
(813) 309-7881
Mailing address
1924 E FRIERSON AVE, TAMPA, FL 33610-5034
(813) 309-7881
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1619432093
—
FL
Enumeration date
06/28/2020
Last updated
06/29/2020
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