Provider Demographics
NPI:1245612886
Name:BRYANT, ANDREA M (PHR)
Entity Type:Individual
Prefix:
First Name:ANDREA
Middle Name:M
Last Name:BRYANT
Suffix:
Gender:F
Credentials:PHR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:200 EASTERN PKWY
Mailing Address - Street 2:SUITE 2-R
Mailing Address - City:NEWARK
Mailing Address - State:NJ
Mailing Address - Zip Code:07106-3446
Mailing Address - Country:US
Mailing Address - Phone:862-220-2395
Mailing Address - Fax:973-732-0191
Practice Address - Street 1:200 EASTERN PKWY
Practice Address - Street 2:SUITE 2-R
Practice Address - City:NEWARK
Practice Address - State:NJ
Practice Address - Zip Code:07106-3446
Practice Address - Country:US
Practice Address - Phone:862-220-2395
Practice Address - Fax:973-732-0191
Is Sole Proprietor?:Yes
Enumeration Date:2015-06-19
Last Update Date:2015-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor
No171M00000XOther Service ProvidersCase Manager/Care Coordinator