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General NPI Number Information
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NPI Number | 1376910059
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Entity Type | Individual
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Provider Name | BRIE-ANNA MICHELLE WILLEY L.M.H.C., C.R.C.
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Gender | Female
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Dates
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Enumeration Date | 08/28/2015
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Last Update Date | 02/28/2020
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Provider Practice Location Address
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Address Line | 600 8TH AVE W STE 200
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City | PALMETTO
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State | FL
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Zip | 34221-5162
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Country | US
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Telephone | 941-757-8597
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Fax | 855-240-3641
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Provider Business Mailing Address
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Address Line | PO BOX 2063
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City | PALMETTO
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State | FL
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Zip | 34220-2063
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Country | US
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Telephone | 941-807-2670
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Fax | 855-240-3641
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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 | MH12927
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License Number State | FL
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