Provider Demographics
NPI:1629891858
Name:WASHINGTON, BRIANNA J
Entity type:Individual
Prefix:
First Name:BRIANNA
Middle Name:J
Last Name:WASHINGTON
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 1:450 CENTER AVE APT 11
Mailing Address - Street 2:
Mailing Address - City:CUYAHOGA FLS
Mailing Address - State:OH
Mailing Address - Zip Code:44221-2877
Mailing Address - Country:US
Mailing Address - Phone:330-351-8346
Mailing Address - Fax:000-000-0000
Practice Address - Street 1:3725 HILDANA RD
Practice Address - Street 2:
Practice Address - City:SHAKER HEIGHTS
Practice Address - State:OH
Practice Address - Zip Code:44120-5005
Practice Address - Country:US
Practice Address - Phone:216-394-7638
Practice Address - Fax:216-205-4628
Is Sole Proprietor?:No
Enumeration Date:2024-11-05
Last Update Date:2024-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician