=====================================================
General NPI Number Information
=====================================================
NPI Number | 1972270478
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | MRS. BRIEANNA NICOLE ALEXANDER
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 08/24/2021
-----------------------------------------------------
Last Update Date | 08/24/2021
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 35 SUMMER ST STE 202
-----------------------------------------------------
City | TAUNTON
-----------------------------------------------------
State | MA
-----------------------------------------------------
Zip | 02780-3469
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 508-747-0402
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 95 PARKVIEW ST APT 402
-----------------------------------------------------
City | WEYMOUTH
-----------------------------------------------------
State | MA
-----------------------------------------------------
Zip | 02190-3938
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 585-208-3018
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 101YM0800X
-----------------------------------------------------
Taxonomy Name | Mental Health Counselor
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------