Provider Demographics
NPI:1396074662
Name:BRYANT, HEATHER WHITE (LPC)
Entity type:Individual
Prefix:
First Name:HEATHER
Middle Name:WHITE
Last Name:BRYANT
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:HEATHER
Other - Middle Name:L
Other - Last Name:WHITE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:118 EAST MOBILE ST
Mailing Address - Street 2:SUITE 106
Mailing Address - City:FLORENCE
Mailing Address - State:AL
Mailing Address - Zip Code:35630
Mailing Address - Country:US
Mailing Address - Phone:256-263-5280
Mailing Address - Fax:256-263-5280
Practice Address - Street 1:118 EAST MOBILE ST
Practice Address - Street 2:SUITE 106
Practice Address - City:FLORENCE
Practice Address - State:AL
Practice Address - Zip Code:35630
Practice Address - Country:US
Practice Address - Phone:256-263-5280
Practice Address - Fax:256-263-5280
Is Sole Proprietor?:No
Enumeration Date:2009-12-16
Last Update Date:2014-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL3136101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor