Provider Demographics
NPI:1700280609
Name:BRYANT, TONGA THERESE (LPC)
Entity Type:Individual
Prefix:
First Name:TONGA
Middle Name:THERESE
Last Name:BRYANT
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1701 E COLTER ST UNIT 202
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85016-3374
Mailing Address - Country:US
Mailing Address - Phone:480-420-9603
Mailing Address - Fax:480-393-7142
Practice Address - Street 1:5151 N 16TH ST APT 1010
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85016-3807
Practice Address - Country:US
Practice Address - Phone:480-420-9603
Practice Address - Fax:480-393-7142
Is Sole Proprietor?:No
Enumeration Date:2014-10-21
Last Update Date:2023-10-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA4694101YP2500X
AZ18871101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional