Provider Demographics
NPI:1346475464
Name:BRYANT, SAMANTHA JACQUELYN (LMFT)
Entity Type:Individual
Prefix:MRS
First Name:SAMANTHA
Middle Name:JACQUELYN
Last Name:BRYANT
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1826 SNAKE RIVER RD STE D
Mailing Address - Street 2:
Mailing Address - City:KATY
Mailing Address - State:TX
Mailing Address - Zip Code:77449-7750
Mailing Address - Country:US
Mailing Address - Phone:281-394-1379
Mailing Address - Fax:
Practice Address - Street 1:1826 SNAKE RIVER RD STE D
Practice Address - Street 2:
Practice Address - City:KATY
Practice Address - State:TX
Practice Address - Zip Code:77449-7750
Practice Address - Country:US
Practice Address - Phone:281-394-1379
Practice Address - Fax:918-895-6917
Is Sole Proprietor?:No
Enumeration Date:2009-05-19
Last Update Date:2020-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX203623101YM0800X, 101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health