Provider Demographics
NPI:1316606056
Name:STRICKLAND, BRIONNA
Entity type:Individual
Prefix:
First Name:BRIONNA
Middle Name:
Last Name:STRICKLAND
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 1:150 ZACHERY RD
Mailing Address - Street 2:
Mailing Address - City:FRANKLIN
Mailing Address - State:GA
Mailing Address - Zip Code:30217-7002
Mailing Address - Country:US
Mailing Address - Phone:706-594-2118
Mailing Address - Fax:
Practice Address - Street 1:6003 VETERANS PKWY STE 206
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:GA
Practice Address - Zip Code:31909-6200
Practice Address - Country:US
Practice Address - Phone:706-905-5525
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-12-09
Last Update Date:2021-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARBT-21-195703106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior TechnicianGroup - Single Specialty