Provider Demographics
NPI:1508315664
Name:EASLEY, ADRIANE (MAPC)
Entity Type:Individual
Prefix:MS
First Name:ADRIANE
Middle Name:
Last Name:EASLEY
Suffix:
Gender:F
Credentials:MAPC
Other - Prefix:MS
Other - First Name:ADRIANE
Other - Middle Name:ANTOINETTE
Other - Last Name:PARHAM
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MAPC
Mailing Address - Street 1:24709 PARHAM LN
Mailing Address - Street 2:
Mailing Address - City:NORTH DINWIDDIE
Mailing Address - State:VA
Mailing Address - Zip Code:23805-9435
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1469 JOHNSTON WILLIS DR
Practice Address - Street 2:
Practice Address - City:NORTH CHESTERFIELD
Practice Address - State:VA
Practice Address - Zip Code:23235-4730
Practice Address - Country:US
Practice Address - Phone:804-477-6393
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-09-29
Last Update Date:2016-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst