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NPI 1265312912

NPI 1265312912 : BRIANNA KNIGHT : RIVERHEAD, NY

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General NPI Number Information
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    NPI Number           |    1265312912
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    Entity Type          |    Individual 
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    Provider Name        |    BRIANNA KNIGHT
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    Gender               |    Female 
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Dates
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    Enumeration Date     |    09/04/2025
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    Last Update Date     |    09/04/2025
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Provider Practice Location Address
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    Address Line         |    400 W MAIN ST 
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    City                 |    RIVERHEAD
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    State                |    NY
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    Zip                  |    11901-2813
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    Country              |    US
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    Telephone            |    631-369-0104
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    2 CHEYENNE CT 
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    City                 |    CORAM
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    State                |    NY
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    Zip                  |    11727-1503
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    Country              |    US
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    Telephone            |    
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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        |    101YA0400X
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    Taxonomy Name        |    Addiction (Substance Use Disorder) Counselor
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    License Number       |    34706
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    License Number State |    NY
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