Most Relevant Information
Provider Data
| NPI Number: | 1003507864 |
| Provider Name: | PAYTON M. BRYANT |
| Entity Type: | Individual |
| Taxonomy Code: | 106S00000X |
| Specialty: | Behavior Technician |
| License Number: |
Most Important Dates
| Enumeration Date: | 05/15/2023 |
| Last Updated: | 04/03/2024 |
Provider Practice Location
1887 SE PORT ST LUCIE BLVD
PORT ST LUCIE
FL
349525530
Practice Location Phone/Fax
| Phone: | 7724630444 |
| Fax: | 7722191339 |
Provider Mailing Location
4600 WILLOW BEND DR
MELBOURNE
FL
329357150
Provider Mailing Phone/Fax
| Phone: | 7049287917 |
| Fax: |