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General NPI Number Information
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NPI Number | 1063396810
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Entity Type | Individual
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Provider Name | BRIANA LEIGH-GROSE WHALEY RMHCI, MA, MS, MDIV,
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Gender | Female
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Dates
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Enumeration Date | 08/04/2025
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Last Update Date | 08/04/2025
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Provider Practice Location Address
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Address Line | 1250 W EAU GALLIE BLVD STE A
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City | MELBOURNE
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State | FL
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Zip | 32935-5385
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Country | US
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Telephone | 727-424-9417
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Fax |
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Provider Business Mailing Address
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Address Line | 810 NEW HAMPTON WAY
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City | MERRITT ISLAND
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State | FL
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Zip | 32953-3221
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Country | US
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Telephone | 727-424-8417
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | IMH28016
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License Number State | FL
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