Provider Demographics
NPI:1942635123
Name:BRYANT, KATHRYN HOLLIS (LMSW)
Entity Type:Individual
Prefix:MS
First Name:KATHRYN
Middle Name:HOLLIS
Last Name:BRYANT
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:660 RALPH MCGILL BLVD NE
Mailing Address - Street 2:APT. 3120
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30312-1149
Mailing Address - Country:US
Mailing Address - Phone:404-583-9348
Mailing Address - Fax:
Practice Address - Street 1:1291 STANLEY RD NW
Practice Address - Street 2:
Practice Address - City:KENNESAW
Practice Address - State:GA
Practice Address - Zip Code:30152-4359
Practice Address - Country:US
Practice Address - Phone:770-427-0147
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-09-06
Last Update Date:2013-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAMSW005208104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker