Provider Demographics
NPI:1225764939
Name:PERO, BRIANA (MFT-IT)
Entity Type:Individual
Prefix:
First Name:BRIANA
Middle Name:
Last Name:PERO
Suffix:
Gender:F
Credentials:MFT-IT
Other - Prefix:
Other - First Name:BRIE
Other - Middle Name:
Other - Last Name:PERO
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:831 E WASHINGTON AVE
Mailing Address - Street 2:
Mailing Address - City:MADISON
Mailing Address - State:WI
Mailing Address - Zip Code:53703-2935
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1625 WALDORF BLVD APT 206
Practice Address - Street 2:
Practice Address - City:MADISON
Practice Address - State:WI
Practice Address - Zip Code:53719-4569
Practice Address - Country:US
Practice Address - Phone:608-963-3445
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-07-26
Last Update Date:2022-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty