Provider Demographics
NPI:1396142998
Name:DUNHAM, BRIANNA LOUISE
Entity type:Individual
Prefix:
First Name:BRIANNA
Middle Name:LOUISE
Last Name:DUNHAM
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 1:4048 CARMANWOOD DR
Mailing Address - Street 2:
Mailing Address - City:FLINT
Mailing Address - State:MI
Mailing Address - Zip Code:48507-5502
Mailing Address - Country:US
Mailing Address - Phone:819-210-5424
Mailing Address - Fax:
Practice Address - Street 1:4048 CARMANWOOD DR
Practice Address - Street 2:
Practice Address - City:FLINT
Practice Address - State:MI
Practice Address - Zip Code:48507-5502
Practice Address - Country:US
Practice Address - Phone:819-210-5424
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-11-25
Last Update Date:2018-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst