Provider Demographics
NPI:1902778491
Name:AYALA, BRIANNA V
Entity type:Individual
Prefix:
First Name:BRIANNA
Middle Name:V
Last Name:AYALA
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 1:5790 SE NORMANDY AVE
Mailing Address - Street 2:
Mailing Address - City:STUART
Mailing Address - State:FL
Mailing Address - Zip Code:34997-7889
Mailing Address - Country:US
Mailing Address - Phone:772-289-0577
Mailing Address - Fax:
Practice Address - Street 1:11718 SE FEDERAL HWY # 245
Practice Address - Street 2:
Practice Address - City:HOBE SOUND
Practice Address - State:FL
Practice Address - Zip Code:33455-5303
Practice Address - Country:US
Practice Address - Phone:772-289-0577
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-09-23
Last Update Date:2025-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician