Provider Demographics
NPI:1588747851
Name:BRYANT, ANNE MARIE (LPC,)
Entity type:Individual
Prefix:MRS
First Name:ANNE MARIE
Middle Name:
Last Name:BRYANT
Suffix:
Gender:F
Credentials:LPC,
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:628 CHESTNUT CT
Mailing Address - Street 2:
Mailing Address - City:SPRINGFIELD
Mailing Address - State:TN
Mailing Address - Zip Code:37172-5856
Mailing Address - Country:US
Mailing Address - Phone:615-618-4677
Mailing Address - Fax:
Practice Address - Street 1:101 5TH AVE W
Practice Address - Street 2:SUITE 202
Practice Address - City:SPRINGFIELD
Practice Address - State:TN
Practice Address - Zip Code:37172-2430
Practice Address - Country:US
Practice Address - Phone:615-382-4550
Practice Address - Fax:615-382-4549
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN0000001928101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional