Individual
ALEXUS SHONTEL BRYANT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
351 WAGONER DR, FAYETTEVILLE, NC 28303-4608
(910) 491-0061
Mailing address
1811 CRIMSON WAY APT E, FAYETTEVILLE, NC 28306-3690
(910) 578-8073
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
02/22/2021
Last updated
02/22/2021
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