Provider Demographics
NPI:1134482995
Name:BRYSON, MONIKA ELISABETH (B S)
Entity Type:Individual
Prefix:
First Name:MONIKA
Middle Name:ELISABETH
Last Name:BRYSON
Suffix:
Gender:F
Credentials:B S
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4439 BIBLE CHURCH RD
Mailing Address - Street 2:
Mailing Address - City:BOILING SPRINGS
Mailing Address - State:SC
Mailing Address - Zip Code:29316-5702
Mailing Address - Country:US
Mailing Address - Phone:864-978-8709
Mailing Address - Fax:864-582-7111
Practice Address - Street 1:1530 ASHEVILLE HWY
Practice Address - Street 2:
Practice Address - City:SPARTANBURG
Practice Address - State:SC
Practice Address - Zip Code:29303-2006
Practice Address - Country:US
Practice Address - Phone:864-582-5431
Practice Address - Fax:864-582-7111
Is Sole Proprietor?:Yes
Enumeration Date:2012-06-18
Last Update Date:2012-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health