Provider Demographics
NPI:1821773797
Name:BRYANT, BAILEY GRACE
Entity Type:Individual
Prefix:MS
First Name:BAILEY
Middle Name:GRACE
Last Name:BRYANT
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:506 N PALMERS CHAPEL RD
Mailing Address - Street 2:
Mailing Address - City:WHITE HOUSE
Mailing Address - State:TN
Mailing Address - Zip Code:37188-9069
Mailing Address - Country:US
Mailing Address - Phone:615-829-0714
Mailing Address - Fax:
Practice Address - Street 1:506 N PALMERS CHAPEL RD
Practice Address - Street 2:
Practice Address - City:WHITE HOUSE
Practice Address - State:TN
Practice Address - Zip Code:37188-9069
Practice Address - Country:US
Practice Address - Phone:615-829-0714
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-06-19
Last Update Date:2023-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician