Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101YP2500X | Professional Counselor | 76352 | TX |
NPI | 1003317181 |
---|---|
Provider Name | Monalisa G Bryant |
First Address | Houston, TX 77052-3732 |
Second Address | Houston, TX 77027-5740 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 23/02/2018 |
Last Update Date | 10/06/2019 |