Provider Demographics
NPI:1093609042
Name:DELGADO, BRIANNE RUSSELL (MTBC)
Entity type:Individual
Prefix:MRS
First Name:BRIANNE
Middle Name:RUSSELL
Last Name:DELGADO
Suffix:
Gender:F
Credentials:MTBC
Other - Prefix:
Other - First Name:BRIANNE
Other - Middle Name:ELIZABETH
Other - Last Name:RUSSELL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MTBC
Mailing Address - Street 1:15030 SORRENTO BAY CT
Mailing Address - Street 2:
Mailing Address - City:WILLIS
Mailing Address - State:TX
Mailing Address - Zip Code:77318-2100
Mailing Address - Country:US
Mailing Address - Phone:409-679-7742
Mailing Address - Fax:
Practice Address - Street 1:15030 SORRENTO BAY CT
Practice Address - Street 2:
Practice Address - City:WILLIS
Practice Address - State:TX
Practice Address - Zip Code:77318-2100
Practice Address - Country:US
Practice Address - Phone:409-679-7742
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-06-04
Last Update Date:2025-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
16874225A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225A00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMusic Therapist