Individual
MATTHEW CHRISTOPHER BRYAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LCSW
Contact information
Practice address
185 OSPREY CT, SANTA TERESA, NM 88008-9502
(915) 873-5672
Mailing address
185 OSPREY CT, SANTA TERESA, NM 88008-9502
(915) 873-5672
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
SWB-2022-0411
NM
Other
Enumeration date
08/10/2020
Last updated
07/27/2023
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