Provider Demographics
NPI:1033990916
Name:DOAK, BRIAN CONNOR JR
Entity Type:Individual
Prefix:MR
First Name:BRIAN
Middle Name:CONNOR
Last Name:DOAK
Suffix:JR
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:341 KNOLLS PL
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37211-7405
Mailing Address - Country:US
Mailing Address - Phone:443-255-6757
Mailing Address - Fax:
Practice Address - Street 1:424 CHURCH ST STE 2000
Practice Address - Street 2:
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37219-3304
Practice Address - Country:US
Practice Address - Phone:443-255-6757
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-10-09
Last Update Date:2023-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNRBT-23-299653106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician