Individual
MRS. STACIE L. BRYANT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.S., CCC-SLP
Contact information
Practice address
603 PORT DRIVE, AVON, IN 46123-4612
(317) 272-8238
Mailing address
603 PORT DR, AVON, IN 46123-1239
(317) 272-8238
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
22003399A
IN
Other
Enumeration date
10/29/2009
Last updated
10/29/2009
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