Provider Demographics
NPI:1073288726
Name:BRAILEY, DEMTRIUS (CLS-T(ASCP))
Entity Type:Individual
Prefix:
First Name:DEMTRIUS
Middle Name:
Last Name:BRAILEY
Suffix:
Gender:F
Credentials:CLS-T(ASCP)
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:40070 CANE ST STE 400
Mailing Address - Street 2:
Mailing Address - City:SLIDELL
Mailing Address - State:LA
Mailing Address - Zip Code:70461-3757
Mailing Address - Country:US
Mailing Address - Phone:985-326-8355
Mailing Address - Fax:985-265-4137
Practice Address - Street 1:40070 CANE ST STE 400
Practice Address - Street 2:
Practice Address - City:SLIDELL
Practice Address - State:LA
Practice Address - Zip Code:70461-3757
Practice Address - Country:US
Practice Address - Phone:985-326-8355
Practice Address - Fax:985-265-4137
Is Sole Proprietor?:Yes
Enumeration Date:2021-08-14
Last Update Date:2022-05-27
Deactivation Date:
Deactivation Code:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246RM2200XTechnologists, Technicians & Other Technical Service ProvidersTechnician, PathologyMedical Laboratory