Healthcare Provider Details

I. General information

NPI: 1912653320
Provider Name (Legal Business Name): BRIANNA MARTIN QMHS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/24/2022
Last Update Date: 08/07/2026
Certification Date: 08/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

45875 BELL SCHOOL RD STE B
E LIVERPOOL OH
43920-8728
US

IV. Provider business mailing address

45875 BELL SCHOOL RD STE B
E LIVERPOOL OH
43920-8728
US

V. Phone/Fax

Practice location:
  • Phone: 330-397-6007
  • Fax: 234-254-5655
Mailing address:
  • Phone: 234-254-5656
  • Fax: 234-254-5655

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: