Individual
MS. KATRINA BRYANT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
300 E 1 ST, PORTALES, NM 88130
(505) 359-1221
(505) 359-1075
Mailing address
2024 CAMEO, CLOVIS, NM 88101
(505) 791-3611
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
10/25/2006
Last updated
07/08/2007
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