Bryant, Ivory Myrick

Bryant, Ivory Myrick is an individual health care provider with primary practice located at 545 Old Norcross Rd Suite 100, Lawrenceville GA 30046-3389. She recently has only one registered license in Speech, Language and Hearing Service Providers / Speech-Language Pathologist, which is considered as her primary health care specialty. Bryant, Ivory Myrick can be contacted via phone (678) 377-2833.

Contact Information

Primary practice address
545 Old Norcross Rd Suite 100 Lawrenceville GA 30046-3389
Phone: (678) 377-2833
Fax: (678) 377-2882
Website:
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Health care specialties

SpecialtyCodeLicense #State
Speech, Language and Hearing Service Providers / Speech-Language Pathologist 235Z00000X SLP006196 Georgia

Profile Details

NPI number 1104818764
LBN Legal business name Bryant, Ivory Myrick
Credentials M.S., CCC-SLP
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 19th, 2005
Last updated Apr 6th, 2011 - about 15 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1104818764 NPPES
Georgia Other 392229867A ACTIVE MEDICAID

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