Individual
MS. KATRINA RENEE BRYANT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MS, LCAS
Contact information
Practice address
5017 ELIZABETH RD, CHARLOTTE, NC 28269-4534
(704) 325-8336
(704) 825-8356
Mailing address
1213 W MOREHEAD ST FL 5, CHARLOTTE, NC 28208-5576
(704) 325-8336
(704) 325-8356
Taxonomy
Speciality
Code
Description
License number
State
320600000X
Intellectual and/or Developmental Disabilities Residential Treatment Facility
Primary
—
—
Other
Enumeration date
10/06/2023
Last updated
10/06/2023
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