Provider Demographics
NPI:1104650738
Name:WALKER, BRIANA DANIELLE
Entity type:Individual
Prefix:
First Name:BRIANA
Middle Name:DANIELLE
Last Name:WALKER
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 1:2794 MERIDIAN DR UNIT 2
Mailing Address - Street 2:
Mailing Address - City:GREENVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:27834-6255
Mailing Address - Country:US
Mailing Address - Phone:609-906-1965
Mailing Address - Fax:
Practice Address - Street 1:2794 MERIDIAN DR UNIT 2
Practice Address - Street 2:
Practice Address - City:GREENVILLE
Practice Address - State:NC
Practice Address - Zip Code:27834-6255
Practice Address - Country:US
Practice Address - Phone:609-906-1965
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-08-27
Last Update Date:2024-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician