Provider Demographics
NPI:1578282141
Name:BARGER, BRIAH
Entity Type:Individual
Prefix:
First Name:BRIAH
Middle Name:
Last Name:BARGER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:BRIAH
Other - Middle Name:
Other - Last Name:LUCKEY
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:ATR-BC, LPC
Mailing Address - Street 1:169 EAST ST
Mailing Address - Street 2:
Mailing Address - City:NEW HAVEN
Mailing Address - State:CT
Mailing Address - Zip Code:06511-5809
Mailing Address - Country:US
Mailing Address - Phone:203-927-4212
Mailing Address - Fax:
Practice Address - Street 1:169 EAST ST
Practice Address - Street 2:
Practice Address - City:NEW HAVEN
Practice Address - State:CT
Practice Address - Zip Code:06511-5809
Practice Address - Country:US
Practice Address - Phone:203-927-4212
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-08-25
Last Update Date:2022-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes221700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersArt Therapist