Provider Demographics
NPI:1477061117
Name:CAROSIO, BREANNA KATHLEEN
Entity Type:Individual
Prefix:
First Name:BREANNA
Middle Name:KATHLEEN
Last Name:CAROSIO
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 1:15045 5TH AVE SW UNIT 535
Mailing Address - Street 2:
Mailing Address - City:BURIEN
Mailing Address - State:WA
Mailing Address - Zip Code:98166-5146
Mailing Address - Country:US
Mailing Address - Phone:206-319-8948
Mailing Address - Fax:
Practice Address - Street 1:15045 5TH AVE SW UNIT 535
Practice Address - Street 2:
Practice Address - City:BURIEN
Practice Address - State:WA
Practice Address - Zip Code:98166-5146
Practice Address - Country:US
Practice Address - Phone:206-319-8948
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-01-16
Last Update Date:2021-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor