Provider Demographics
NPI:1710545116
Name:BRYCE, GEORGIA A (LMFT)
Entity Type:Individual
Prefix:MISS
First Name:GEORGIA
Middle Name:A
Last Name:BRYCE
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 1:2675 VIRGINIA CV
Mailing Address - Street 2:
Mailing Address - City:RIVERDALE
Mailing Address - State:GA
Mailing Address - Zip Code:30296-6034
Mailing Address - Country:US
Mailing Address - Phone:305-494-0700
Mailing Address - Fax:954-901-2778
Practice Address - Street 1:555 WINDERLEY PL STE 300
Practice Address - Street 2:
Practice Address - City:MAITLAND
Practice Address - State:FL
Practice Address - Zip Code:32751-7133
Practice Address - Country:US
Practice Address - Phone:786-471-8312
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-05-31
Last Update Date:2024-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMT3673106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist