Provider Demographics
NPI:1558860551
Name:MINOR, BRIYON (LAPC)
Entity Type:Individual
Prefix:
First Name:BRIYON
Middle Name:
Last Name:MINOR
Suffix:
Gender:F
Credentials:LAPC
Other - Prefix:MS
Other - First Name:BRIYON
Other - Middle Name:
Other - Last Name:MINOR
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:1910 OAKLEAF LN
Mailing Address - Street 2:
Mailing Address - City:LITHIA SPRINGS
Mailing Address - State:GA
Mailing Address - Zip Code:30122-2784
Mailing Address - Country:US
Mailing Address - Phone:678-334-9033
Mailing Address - Fax:
Practice Address - Street 1:1910 OAKLEAF LN
Practice Address - Street 2:
Practice Address - City:LITHIA SPRINGS
Practice Address - State:GA
Practice Address - Zip Code:30122-2784
Practice Address - Country:US
Practice Address - Phone:678-334-9033
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-02-05
Last Update Date:2023-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
KY101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program