Individual
DERECA BRYANT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSWA
Contact information
Practice address
1817 ALEXANDER HIGHLANDS DR APT 204, CHARLOTTE, NC 28262-5524
(704) 488-1389
Mailing address
1817 ALEXANDER HIGHLANDS DR APT 204, CHARLOTTE, NC 28262-5524
(704) 488-1389
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
P021970
NC
Other
Enumeration date
05/19/2025
Last updated
05/19/2025
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