Provider Demographics
NPI:1316337009
Name:PRIOLEAU, BRITTANY
Entity type:Individual
Prefix:MS
First Name:BRITTANY
Middle Name:
Last Name:PRIOLEAU
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 1:11101 GEORGIA AVE UNIT 551
Mailing Address - Street 2:
Mailing Address - City:WHEATON
Mailing Address - State:MD
Mailing Address - Zip Code:20902-7607
Mailing Address - Country:US
Mailing Address - Phone:843-555-7354
Mailing Address - Fax:
Practice Address - Street 1:11101 GEORGIA AVE UNIT 551
Practice Address - Street 2:
Practice Address - City:WHEATON
Practice Address - State:MD
Practice Address - Zip Code:20902-7607
Practice Address - Country:US
Practice Address - Phone:843-557-3545
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-02-02
Last Update Date:2015-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCLGPC0017101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health