Provider Demographics
NPI:1467008334
Name:NOLAN, BRIA ELIZABETH
Entity Type:Individual
Prefix:MS
First Name:BRIA
Middle Name:ELIZABETH
Last Name:NOLAN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:N/A
Other - Middle Name:N/A
Other - Last Name:N/A
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:1200 W CHEYENNE AVE APT 2130
Mailing Address - Street 2:
Mailing Address - City:NORTH LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89030-7831
Mailing Address - Country:US
Mailing Address - Phone:509-608-0185
Mailing Address - Fax:
Practice Address - Street 1:1200 W CHEYENNE AVE APT 2130
Practice Address - Street 2:
Practice Address - City:NORTH LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89030-7831
Practice Address - Country:US
Practice Address - Phone:509-608-0185
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-08-15
Last Update Date:2019-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician