Provider Demographics
NPI:1376259093
Name:BINGERMAN, BRIANNA (LMBT)
Entity Type:Individual
Prefix:
First Name:BRIANNA
Middle Name:
Last Name:BINGERMAN
Suffix:
Gender:F
Credentials:LMBT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:200 CAPE FEAR CIR STE 2
Mailing Address - Street 2:
Mailing Address - City:SNEADS FERRY
Mailing Address - State:NC
Mailing Address - Zip Code:28460-9192
Mailing Address - Country:US
Mailing Address - Phone:910-327-0022
Mailing Address - Fax:910-327-0337
Practice Address - Street 1:200 CAPE FEAR CIR STE 2
Practice Address - Street 2:
Practice Address - City:SNEADS FERRY
Practice Address - State:NC
Practice Address - Zip Code:28460-9192
Practice Address - Country:US
Practice Address - Phone:910-327-0022
Practice Address - Fax:910-327-0337
Is Sole Proprietor?:No
Enumeration Date:2023-01-26
Last Update Date:2023-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY16611225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist