Provider Demographics
NPI:1912349002
Name:BRYANT, AMBER ALICIA (MS CCC- SLP)
Entity Type:Individual
Prefix:MRS
First Name:AMBER
Middle Name:ALICIA
Last Name:BRYANT
Suffix:
Gender:F
Credentials:MS CCC- SLP
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Mailing Address - Street 1:2319 HIGHWAY 145
Mailing Address - Street 2:PO BOX 420
Mailing Address - City:SALTILLO
Mailing Address - State:MS
Mailing Address - Zip Code:38866-9199
Mailing Address - Country:US
Mailing Address - Phone:662-869-9980
Mailing Address - Fax:662-869-9970
Practice Address - Street 1:2319 HIGHWAY 145
Practice Address - Street 2:
Practice Address - City:SALTILLO
Practice Address - State:MS
Practice Address - Zip Code:38866-9199
Practice Address - Country:US
Practice Address - Phone:662-869-9980
Practice Address - Fax:662-869-9970
Is Sole Proprietor?:No
Enumeration Date:2013-07-18
Last Update Date:2013-07-18
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MSS2182235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist