Individual
MR. KENNETH WAYNE BRYANT JR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LPC A
Contact information
Practice address
405 NASH ST W STE 200, WILSON, NC 27893-3761
(252) 360-1489
(252) 991-6570
Mailing address
405 NASH ST W STE 200, WILSON, NC 27893-3761
(252) 360-1489
(252) 991-6570
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
A15365
NC
101YP2500X
Professional Counselor
Primary
A15365
NC
Other
Enumeration date
01/07/2020
Last updated
04/03/2020
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