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NPI 1427844570

NPI 1427844570 : BRIANA CARESSE GRAYSON : RICHMOND HILL, GA

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General NPI Number Information
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    NPI Number           |    1427844570
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    Entity Type          |    Individual 
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    Provider Name        |    BRIANA CARESSE GRAYSON
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    Gender               |    Female 
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Dates
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    Enumeration Date     |    04/16/2025
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    Last Update Date     |    04/16/2025
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Provider Practice Location Address
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    Address Line         |    2451B US HIGHWAY 17 
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    City                 |    RICHMOND HILL
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    State                |    GA
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    Zip                  |    31324-3397
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    Country              |    US
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    Telephone            |    615-560-6622
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    100 HARLEY LN APT 1311 
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    City                 |    POOLER
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    State                |    GA
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    Zip                  |    31322-3919
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    Country              |    US
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    Telephone            |    936-520-2444
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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        |    106S00000X
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    Taxonomy Name        |    Behavior Technician
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    License Number       |    
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    License Number State |    
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