Provider Demographics
NPI:1194973610
Name:GURN, BRIANNA
Entity type:Individual
Prefix:
First Name:BRIANNA
Middle Name:
Last Name:GURN
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 1:155 W MAIN ST
Mailing Address - Street 2:APT 309
Mailing Address - City:VERNON
Mailing Address - State:CT
Mailing Address - Zip Code:06066-3541
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:155 W MAIN ST
Practice Address - Street 2:APT 309
Practice Address - City:VERNON
Practice Address - State:CT
Practice Address - Zip Code:06066-3541
Practice Address - Country:US
Practice Address - Phone:860-617-0247
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-09-09
Last Update Date:2008-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health