Provider Demographics
NPI:1659684876
Name:BRYANT&ASSOCIATES COMPREHENSIVE SPEECH THERAPY, LLC
Entity Type:Organization
Organization Name:BRYANT&ASSOCIATES COMPREHENSIVE SPEECH THERAPY, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:HOPE
Authorized Official - Middle Name:
Authorized Official - Last Name:ROZIER-BRYANT
Authorized Official - Suffix:
Authorized Official - Credentials:CCC/SLP
Authorized Official - Phone:803-943-3191
Mailing Address - Street 1:4435 WALTERBORO HIGHWAY
Mailing Address - Street 2:PO BOX 265
Mailing Address - City:VARNVILLE
Mailing Address - State:SC
Mailing Address - Zip Code:29944-2162
Mailing Address - Country:US
Mailing Address - Phone:803-943-3191
Mailing Address - Fax:
Practice Address - Street 1:4435 WALTERBORO HIGHWAY
Practice Address - Street 2:987B WEST CAROLINA AVENUE
Practice Address - City:VARNVILLE
Practice Address - State:SC
Practice Address - Zip Code:29944-2162
Practice Address - Country:US
Practice Address - Phone:803-943-3191
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-07-16
Last Update Date:2010-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC2027252Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes252Y00000XAgenciesEarly Intervention Provider Agency
Provider Identifiers
StateIdentifier IDID TypeIssuer
SCSA 0709Medicaid