Provider Demographics
NPI:1215737804
Name:FRANTZ, BRYNNA JULIANNE
Entity type:Individual
Prefix:
First Name:BRYNNA
Middle Name:JULIANNE
Last Name:FRANTZ
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:90 S GLADE RD
Mailing Address - Street 2:
Mailing Address - City:FORT OGLETHORPE
Mailing Address - State:GA
Mailing Address - Zip Code:30742-3935
Mailing Address - Country:US
Mailing Address - Phone:706-639-6744
Mailing Address - Fax:
Practice Address - Street 1:90 S GLADE RD
Practice Address - Street 2:
Practice Address - City:FORT OGLETHORPE
Practice Address - State:GA
Practice Address - Zip Code:30742-3935
Practice Address - Country:US
Practice Address - Phone:706-639-6744
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-03-14
Last Update Date:2025-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health