Individual
KELLIE DAWN BRYSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2826 AMICOLA HWY, CHATTANOOGA, TN 37406
(833) 825-5246
Mailing address
9777 HIGHWAY 41, RINGGOLD, GA 30736-8682
(706) 264-8509
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
222118473583
—
GA
Enumeration date
11/25/2020
Last updated
11/25/2020
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