Provider Demographics
NPI:1992488563
Name:GUERRERO, BRIANNA (BA, R-AAC)
Entity type:Individual
Prefix:
First Name:BRIANNA
Middle Name:
Last Name:GUERRERO
Suffix:
Gender:F
Credentials:BA, R-AAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 2394
Mailing Address - Street 2:
Mailing Address - City:LONGVIEW
Mailing Address - State:WA
Mailing Address - Zip Code:98632-8455
Mailing Address - Country:US
Mailing Address - Phone:360-998-3050
Mailing Address - Fax:360-200-6736
Practice Address - Street 1:1131 BROADWAY ST
Practice Address - Street 2:
Practice Address - City:LONGVIEW
Practice Address - State:WA
Practice Address - Zip Code:98632-3830
Practice Address - Country:US
Practice Address - Phone:609-983-0503
Practice Address - Fax:360-200-3736
Is Sole Proprietor?:No
Enumeration Date:2023-08-10
Last Update Date:2024-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
171M00000X
WACG61461598101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor
No171M00000XOther Service ProvidersCase Manager/Care Coordinator