Provider Demographics
NPI:1407428550
Name:BRYANT, TRINITY ANN (PSYD)
Entity Type:Individual
Prefix:
First Name:TRINITY
Middle Name:ANN
Last Name:BRYANT
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:361 MARLOWE CT
Mailing Address - Street 2:
Mailing Address - City:ERIE
Mailing Address - State:CO
Mailing Address - Zip Code:80516-8935
Mailing Address - Country:US
Mailing Address - Phone:317-809-3230
Mailing Address - Fax:
Practice Address - Street 1:361 MARLOWE CT
Practice Address - Street 2:
Practice Address - City:ERIE
Practice Address - State:CO
Practice Address - Zip Code:80516-8935
Practice Address - Country:US
Practice Address - Phone:317-809-3230
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-07-16
Last Update Date:2021-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
103T00000X
COPYSC.00014493101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor
No103T00000XBehavioral Health & Social Service ProvidersPsychologist