Provider Demographics
NPI:1275199465
Name:TURNER-BRYAN, KIMBERLY KAYANA (LGPC)
Entity Type:Individual
Prefix:MISS
First Name:KIMBERLY
Middle Name:KAYANA
Last Name:TURNER-BRYAN
Suffix:
Gender:F
Credentials:LGPC
Other - Prefix:MISS
Other - First Name:KIMBERLY
Other - Middle Name:KAYANA
Other - Last Name:BRYAN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:3416 OLANDWOOD CT STE 201
Mailing Address - Street 2:
Mailing Address - City:OLNEY
Mailing Address - State:MD
Mailing Address - Zip Code:20832-1373
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:3416 OLANDWOOD CT STE 201
Practice Address - Street 2:
Practice Address - City:OLNEY
Practice Address - State:MD
Practice Address - Zip Code:20832-1373
Practice Address - Country:US
Practice Address - Phone:301-969-4060
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-05-14
Last Update Date:2021-01-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
251S00000X
MDLGP10877101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No251S00000XAgenciesCommunity/Behavioral Health