Provider Demographics
NPI:1902998172
Name:BRYANT SMITH, SHIRLEY ANN
Entity Type:Individual
Prefix:MS
First Name:SHIRLEY
Middle Name:ANN
Last Name:BRYANT SMITH
Suffix:
Gender:F
Credentials:
Other - Prefix:MS
Other - First Name:SHIRLEY
Other - Middle Name:ANN
Other - Last Name:BRYANT-SMITH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1600 SW ARCHER RD RM HD-123
Mailing Address - Street 2:
Mailing Address - City:GAINESVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32610-3003
Mailing Address - Country:US
Mailing Address - Phone:352-334-1480
Mailing Address - Fax:352-392-7829
Practice Address - Street 1:1600 SW ARCHER RD RM HD-123
Practice Address - Street 2:
Practice Address - City:GAINESVILLE
Practice Address - State:FL
Practice Address - Zip Code:32610-3003
Practice Address - Country:US
Practice Address - Phone:352-334-1480
Practice Address - Fax:352-392-7829
Is Sole Proprietor?:No
Enumeration Date:2006-09-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker