Provider Demographics
NPI:1154009843
Name:CLIFFORD, BRIEANNA CHAUSEE
Entity type:Individual
Prefix:
First Name:BRIEANNA
Middle Name:CHAUSEE
Last Name:CLIFFORD
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 1:316 N 3RD ST
Mailing Address - Street 2:
Mailing Address - City:HAMILTON
Mailing Address - State:MT
Mailing Address - Zip Code:59840-2480
Mailing Address - Country:US
Mailing Address - Phone:406-541-0032
Mailing Address - Fax:
Practice Address - Street 1:316 N 3RD ST
Practice Address - Street 2:
Practice Address - City:HAMILTON
Practice Address - State:MT
Practice Address - Zip Code:59840-2480
Practice Address - Country:US
Practice Address - Phone:406-541-0032
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-07-11
Last Update Date:2023-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT63760101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health