Provider Demographics
NPI:1083071393
Name:PRIESTER, BRIANA REICHGOTT (MT-BC)
Entity Type:Individual
Prefix:MRS
First Name:BRIANA
Middle Name:REICHGOTT
Last Name:PRIESTER
Suffix:
Gender:F
Credentials:MT-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5819 PENN LAIRD DR
Mailing Address - Street 2:
Mailing Address - City:PENN LAIRD
Mailing Address - State:VA
Mailing Address - Zip Code:22846-9523
Mailing Address - Country:US
Mailing Address - Phone:540-908-7676
Mailing Address - Fax:
Practice Address - Street 1:5819 PENN LAIRD DR
Practice Address - Street 2:
Practice Address - City:PENN LAIRD
Practice Address - State:VA
Practice Address - Zip Code:22846-9523
Practice Address - Country:US
Practice Address - Phone:540-908-7676
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-01-19
Last Update Date:2016-01-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN10796225A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225A00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMusic Therapist