Provider Demographics
NPI:1780256065
Name:O'BRYANT, BRITTANY LESHON (MS)
Entity type:Individual
Prefix:MS
First Name:BRITTANY
Middle Name:LESHON
Last Name:O'BRYANT
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:412SUMMIT VILLAGE COURT
Mailing Address - Street 2:
Mailing Address - City:MARIETTA
Mailing Address - State:GA
Mailing Address - Zip Code:30066-5960
Mailing Address - Country:US
Mailing Address - Phone:470-264-8774
Mailing Address - Fax:470-655-6900
Practice Address - Street 1:2910 CANTON HIGHWAY
Practice Address - Street 2:UNIT F
Practice Address - City:BALL GROUND
Practice Address - State:GA
Practice Address - Zip Code:30107-9069
Practice Address - Country:US
Practice Address - Phone:970-264-8774
Practice Address - Fax:470-655-6900
Is Sole Proprietor?:Yes
Enumeration Date:2021-07-15
Last Update Date:2022-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GALPC011196101YP2500X, 101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty