Provider Information for 1104119015
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Dr. CARMEN MELANIE BRYANT M.A., Ed. D., LMHC
Other Names:Former Name:Dr. CARMEN MELANIE CLAYTON M.A., Ed.D., LMHCSex: Female
NPI: 1104119015
Last Updated: 2020-10-08
Certification Date: 2020-10-08
Certification Date: 2020-10-08
Details
| Name | Value | ||||||||
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| NPI | 1104119015 | ||||||||
| Enumeration Date | 2011-05-25 | ||||||||
| NPI Type | NPI-1 Individual | ||||||||
| Sole Proprietor | YES | ||||||||
| Status | Active | ||||||||
| Mailing Address | PO BOX 45549 TACOMA, WA 98448 United States Phone: 253-414-4796 | Fax:253-292-2039 | ||||||||
| Primary Practice Address | 4301 S PINE ST STE 78 TACOMA, WA 98409-7252 United States Phone: 253-414-4796 | Fax:253-292-2039 | ||||||||
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