Provider Demographics
NPI:1811776016
Name:FOLLMER, BRIANNA NOELLE
Entity type:Individual
Prefix:
First Name:BRIANNA
Middle Name:NOELLE
Last Name:FOLLMER
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 1:60 WILLOWSIDE TER
Mailing Address - Street 2:
Mailing Address - City:ALPINE
Mailing Address - State:CA
Mailing Address - Zip Code:91901-1648
Mailing Address - Country:US
Mailing Address - Phone:619-249-5352
Mailing Address - Fax:
Practice Address - Street 1:60 WILLOWSIDE TER
Practice Address - Street 2:
Practice Address - City:ALPINE
Practice Address - State:CA
Practice Address - Zip Code:91901-1648
Practice Address - Country:US
Practice Address - Phone:619-249-5352
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-09-26
Last Update Date:2023-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician