Provider Information for 1073062758
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MICHELE BRYANT LPCC, LICDC-CS
Sex: Female
NPI: 1073062758
Last Updated: 2022-12-07
Certification Date: 2022-01-18
Certification Date: 2022-01-18
Details
| Name | Value | ||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| NPI | 1073062758 | ||||||||||||||||
| Enumeration Date | 2016-09-23 | ||||||||||||||||
| NPI Type | NPI-1 Individual | ||||||||||||||||
| Sole Proprietor | NO | ||||||||||||||||
| Status | Active | ||||||||||||||||
| Mailing Address | 2541 GEORGETOWN AVE TOLEDO, OH 43613-4303 United States Phone: 419-509-7422 | Fax: | ||||||||||||||||
| Primary Practice Address | 3170 W CENTRAL AVE TOLEDO, OH 43606-2945 United States Phone: 567-316-7253 | Fax: | ||||||||||||||||
| Secondary Practice Address(es) | 2541 GEORGETOWN AVE | ||||||||||||||||
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