| Wilma L Bryant Lcsw | |
|
100 N Chestnut St Ste 229 Champaign IL 61820-4856 | |
| (217) 637-7815 | |
| (844) 693-1411 |
| Full Name | Wilma L Bryant Lcsw |
|---|---|
| Speciality | Clinic/center - Adult Mental Health |
| Location | 100 N Chestnut St Ste 229, Champaign, Illinois |
| Authorized Official Name and Position | Wilma L. Bryant (PSYCHOTHERAPY) |
| Authorized Official Contact | 2176377815 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Wilma L Bryant Lcsw 2807 Woodhaven Dr Champaign IL 61822-7573 Ph: (217) 637-7715 | Wilma L Bryant Lcsw 100 N Chestnut St Ste 229 Champaign IL 61820-4856 Ph: (217) 637-7815 |
| NPI Number | 1457846594 |
|---|---|
| Provider Enumeration Date | 06/29/2018 |
| Last Update Date | 06/29/2018 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1457846594 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0850X | Clinic/center - Adult Mental Health | 149005877 (Illinois) | Primary |
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