Provider Demographics
NPI:1376122168
Name:MARTIN, BRIA (MA, BS)
Entity Type:Individual
Prefix:MS
First Name:BRIA
Middle Name:
Last Name:MARTIN
Suffix:
Gender:F
Credentials:MA, BS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:901 DOUGLAS AVE STE 100B
Mailing Address - Street 2:
Mailing Address - City:ALTAMONTE SPRINGS
Mailing Address - State:FL
Mailing Address - Zip Code:32714-2058
Mailing Address - Country:US
Mailing Address - Phone:321-430-6810
Mailing Address - Fax:
Practice Address - Street 1:901 DOUGLAS AVE STE 100B
Practice Address - Street 2:
Practice Address - City:ALTAMONTE SPRINGS
Practice Address - State:FL
Practice Address - Zip Code:32714-2058
Practice Address - Country:US
Practice Address - Phone:321-430-6810
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-04-07
Last Update Date:2021-05-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health