Provider Demographics
NPI:1326404971
Name:WOOD, BRIANNA LLYN (MA)
Entity Type:Individual
Prefix:
First Name:BRIANNA
Middle Name:LLYN
Last Name:WOOD
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:BRIANNA
Other - Middle Name:LLYN
Other - Last Name:CELLI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MA
Mailing Address - Street 1:27407 245TH AVE SE
Mailing Address - Street 2:
Mailing Address - City:MAPLE VALLEY
Mailing Address - State:WA
Mailing Address - Zip Code:98038-2001
Mailing Address - Country:US
Mailing Address - Phone:425-358-1693
Mailing Address - Fax:
Practice Address - Street 1:22443 SE 240TH ST
Practice Address - Street 2:SUITE 202
Practice Address - City:MAPLE VALLEY
Practice Address - State:WA
Practice Address - Zip Code:98038-5898
Practice Address - Country:US
Practice Address - Phone:425-358-1693
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-01-12
Last Update Date:2016-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health