Most Relevant Information
Provider Data
| NPI Number: | 1003690660 |
| Provider Name: | ANGELA BRYAN |
| Entity Type: | Individual |
| Taxonomy Code: | 101YM0800X |
| Specialty: | Counselor |
| License Number: | IMH24550 |
Most Important Dates
| Enumeration Date: | 08/23/2023 |
| Last Updated: | 08/23/2023 |
Provider Practice Location
3270 SUNTREE BLVD STE 103A
MELBOURNE
FL
329407540
Practice Location Phone/Fax
| Phone: | 3217574015 |
| Fax: |
Provider Mailing Location
3270 SUNTREE BLVD STE 103A
MELBOURNE
FL
329407540
Provider Mailing Phone/Fax
| Phone: | 3217574015 |
| Fax: |