Provider Demographics
NPI:1922532704
Name:BRYANT, AISHA
Entity Type:Individual
Prefix:
First Name:AISHA
Middle Name:
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 1:12742 WEDGEDALE CT
Mailing Address - Street 2:
Mailing Address - City:UPPER MARLBORO
Mailing Address - State:MD
Mailing Address - Zip Code:20772-6413
Mailing Address - Country:US
Mailing Address - Phone:240-478-8307
Mailing Address - Fax:
Practice Address - Street 1:4000 ALBEMARLE ST NW
Practice Address - Street 2:SUITE 502
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20016-1851
Practice Address - Country:US
Practice Address - Phone:202-596-5951
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-04-18
Last Update Date:2017-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health