Provider Demographics
NPI:1346575909
Name:BRYSON, CELESTE H (MSCC, PA)
Entity Type:Individual
Prefix:MRS
First Name:CELESTE
Middle Name:H
Last Name:BRYSON
Suffix:
Gender:F
Credentials:MSCC, PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:773 WALKER RD
Mailing Address - Street 2:
Mailing Address - City:DOVER
Mailing Address - State:DE
Mailing Address - Zip Code:19904-2753
Mailing Address - Country:US
Mailing Address - Phone:302-674-2199
Mailing Address - Fax:
Practice Address - Street 1:773 WALKER RD
Practice Address - Street 2:
Practice Address - City:DOVER
Practice Address - State:DE
Practice Address - Zip Code:19904-2753
Practice Address - Country:US
Practice Address - Phone:302-674-2199
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-10-14
Last Update Date:2009-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEB2-0000324103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist