Provider Demographics
NPI:1447774195
Name:BROWN, BRIANNA RAE (LMFT)
Entity type:Individual
Prefix:
First Name:BRIANNA
Middle Name:RAE
Last Name:BROWN
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:110 WINDSOR AVE
Mailing Address - Street 2:
Mailing Address - City:AMERICUS
Mailing Address - State:GA
Mailing Address - Zip Code:31709-3531
Mailing Address - Country:US
Mailing Address - Phone:299-596-1199
Mailing Address - Fax:229-596-1200
Practice Address - Street 1:110 WINDSOR AVE
Practice Address - Street 2:
Practice Address - City:AMERICUS
Practice Address - State:GA
Practice Address - Zip Code:31709-3531
Practice Address - Country:US
Practice Address - Phone:299-596-1199
Practice Address - Fax:229-596-1200
Is Sole Proprietor?:Yes
Enumeration Date:2017-08-02
Last Update Date:2024-11-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAMFT001684106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist