Individual
SHANNON BRYANT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
APSW
Contact information
Practice address
9012 W LAWRENCE AVE, MILWAUKEE, WI 53225-5039
(414) 322-5136
Mailing address
9012 WEST LAWRENCE AVENUE, MILWAUKEE, WI 53225
(414) 322-5136
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
129400-121
WI
Other
Enumeration date
10/08/2014
Last updated
10/08/2014
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