Provider Demographics
NPI:1205556529
Name:BRYANT, SABRINA
Entity type:Individual
Prefix:
First Name:SABRINA
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 1:4826 CLEVELAND AVE NW APT 5
Mailing Address - Street 2:
Mailing Address - City:CANTON
Mailing Address - State:OH
Mailing Address - Zip Code:44709-1163
Mailing Address - Country:US
Mailing Address - Phone:330-432-8494
Mailing Address - Fax:
Practice Address - Street 1:4161 BRIDGEWATER PKWY
Practice Address - Street 2:
Practice Address - City:STOW
Practice Address - State:OH
Practice Address - Zip Code:44224-6191
Practice Address - Country:US
Practice Address - Phone:330-865-4644
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-08-29
Last Update Date:2022-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator