Provider Demographics
NPI:1437519030
Name:CERVANTES, BRIANNA
Entity Type:Individual
Prefix:
First Name:BRIANNA
Middle Name:
Last Name:CERVANTES
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:830 PARKER SQ
Mailing Address - Street 2:
Mailing Address - City:FLOWER MOUND
Mailing Address - State:TX
Mailing Address - Zip Code:75028-7429
Mailing Address - Country:US
Mailing Address - Phone:940-255-6964
Mailing Address - Fax:844-685-8586
Practice Address - Street 1:2600 BOBCAT BLVD STE 200
Practice Address - Street 2:
Practice Address - City:TROPHY CLUB
Practice Address - State:TX
Practice Address - Zip Code:76262-5132
Practice Address - Country:US
Practice Address - Phone:940-255-6964
Practice Address - Fax:844-685-8586
Is Sole Proprietor?:No
Enumeration Date:2016-02-25
Last Update Date:2020-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst