MEDICARE: KAITLYN BRIAR

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YM0800X	Mental Health Counselor

General Provider Information

NPI Number	:	1962122812
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KAITLYN BRIAR

Provider Business Mailing Address
First Line	:	84 REGENCY DR
Second Line	:
City	:	CEDARVILLE
State	:	OH
Zip	:	45314-9501
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	4741 REXWOOD DR
Second Line	:
City	:	DAYTON
State	:	OH
Zip	:	45439-3133
Country	:	US
Telephone Number	:	520-539-2683
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/31/2022
Last Update Date	:	01/05/2024

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Directions to “ KAITLYN BRIAR ” Practice Location

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