NPI Profile for CHANEL BRYANT in FULTON, NY.
Specialty |
Taxonomy Code | Specialty Code | Provider Type | |
School |
1041S0200X | |||
Clinical |
1041C0700X | 80 | Licensed Clinical Social Worker | |
Social Worker |
104100000X |
| NPI # | 1326682295 |
|
| Status | Active | |
| Credentials | LMSW (Licensed Master Social Worker) | |
| Entity | Individual | |
| Enumeration date | 11/04/2019 | |
| Last updated | 05/20/2020 - About 6 years ago | |
| Sole proprietor 1 | No | |
| Identifiers |
|
|
| Hospital affiliation(s) | Not Available |
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CHANEL BRYANT
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