Provider Demographics
NPI:1699452409
Name:AVANT, BRIANNA TAMERA
Entity type:Individual
Prefix:
First Name:BRIANNA
Middle Name:TAMERA
Last Name:AVANT
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3865 CHASEMONT DR
Mailing Address - Street 2:
Mailing Address - City:POWDER SPRINGS
Mailing Address - State:GA
Mailing Address - Zip Code:30127-5635
Mailing Address - Country:US
Mailing Address - Phone:347-707-0161
Mailing Address - Fax:
Practice Address - Street 1:3865 CHASEMONT DR
Practice Address - Street 2:
Practice Address - City:POWDER SPRINGS
Practice Address - State:GA
Practice Address - Zip Code:30127-5635
Practice Address - Country:US
Practice Address - Phone:347-707-0161
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-07-03
Last Update Date:2025-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GASLP012613235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist