Provider Demographics
NPI:1447035308
Name:BRYANT, SAVANNAH SPENCER
Entity type:Individual
Prefix:MRS
First Name:SAVANNAH
Middle Name:SPENCER
Last Name:BRYANT
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7406 SPARKLEBERRY DR
Mailing Address - Street 2:
Mailing Address - City:INDIAN TRAIL
Mailing Address - State:NC
Mailing Address - Zip Code:28079-9457
Mailing Address - Country:US
Mailing Address - Phone:704-771-5849
Mailing Address - Fax:
Practice Address - Street 1:6911 SHANNON WILLOW RD
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28226-1346
Practice Address - Country:US
Practice Address - Phone:704-771-5849
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-08-29
Last Update Date:2023-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional