Individual
EMILY NICOLE BRYAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.A., CCC-SLP
Contact information
Practice address
10056 JEFFERSON WAY, FORT WAYNE, IN 46825-4682
(260) 668-9791
Mailing address
10056 JEFFERSON WAY, FORT WAYNE, IN 46825-2188
(260) 668-9791
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
22004972A
IN
Other
Enumeration date
03/24/2010
Last updated
03/24/2010
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