O'Bryant, Latorja J

O'Bryant, Latorja J is an sole proprietor health care provider with primary practice located at 1 Freedom Way , Augusta GA 30904-6258. She recently has 2 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Social Worker, Behavioral Health & Social Service Providers / Clinical. Behavioral Health & Social Service Providers / Clinical is her primary health care specialty. O'Bryant, Latorja J can be contacted via phone (706) 733-0188.

Contact Information

Primary practice address
1 Freedom Way Augusta GA 30904-6258
Phone: (706) 733-0188
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Social Worker 104100000X MSW003517 Georgia
Behavioral Health & Social Service Providers / Clinical 1041C0700X CSW004597 Georgia

Profile Details

NPI number 1326023409
LBN Legal business name O'Bryant, Latorja J
Credentials Licensed Clinical Social Worker (LCSW)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Dec 12th, 2005
Last updated Jan 17th, 2014 - about 10 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 1326023409 NPPES
Georgia MEDICAID 000606317B

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