Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 1041C0700X | Clinical Social Worker | ||
Y | 1041C0700X | Clinical Social Worker | SW10773 | FL |
NPI | 1003066986 |
---|---|
Provider Name | Bryant C Barbour |
First Address | Tampa, FL 33605 |
Second Address | Tampa, FL 33605 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 26/09/2008 |
Last Update Date | 03/05/2012 |