Provider Demographics
NPI:1598372989
Name:DOW, BRIANA KATHERINE
Entity type:Individual
Prefix:
First Name:BRIANA
Middle Name:KATHERINE
Last Name:DOW
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 1:6956 STATE HIGHWAY 56
Mailing Address - Street 2:
Mailing Address - City:POTSDAM
Mailing Address - State:NY
Mailing Address - Zip Code:13676-3628
Mailing Address - Country:US
Mailing Address - Phone:315-268-0264
Mailing Address - Fax:315-268-0200
Practice Address - Street 1:6956 STATE HIGHWAY 56
Practice Address - Street 2:
Practice Address - City:POTSDAM
Practice Address - State:NY
Practice Address - Zip Code:13676-3628
Practice Address - Country:US
Practice Address - Phone:315-268-0264
Practice Address - Fax:315-268-0200
Is Sole Proprietor?:Yes
Enumeration Date:2020-09-29
Last Update Date:2020-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYP103788106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist