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General NPI Number Information
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NPI Number | 1376364133
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Entity Type | Individual
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Provider Name | BRIANNA MCCANN
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Gender | Female
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Dates
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Enumeration Date | 10/23/2024
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Last Update Date | 10/23/2024
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Provider Practice Location Address
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Address Line | 725 HEARTLAND TRAIL UNIT 301
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City | MADISON
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State | WI
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Zip | 53717
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Country | US
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Telephone | 608-205-4450
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Fax |
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Provider Business Mailing Address
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Address Line | 520 LIMERICK DR. APT. 108
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City | COTTAGE GROVE
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State | WI
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Zip | 53527
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Country | US
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Telephone | 608-449-1866
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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 | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | 1096-228
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License Number State | WI
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