Healthcare Provider Details

I. General information

NPI: 1326961285
Provider Name (Legal Business Name): BRIANNA TERRY
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/30/2026
Last Update Date: 07/30/2026
Certification Date: 07/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2252 KILLEARN CENTER BLVD, TALLAHASSEE, FL 32309 SUITE #300
TALLAHASSEE FL
32309
US

IV. Provider business mailing address

1679 JAYDELL CIR
TALLAHASSEE FL
32308-5401
US

V. Phone/Fax

Practice location:
  • Phone: 850-671-4600
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberIMH27341
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: