Provider Demographics
NPI:1609627405
Name:RICHARDS, BRIANNA ABIGAIL
Entity Type:Individual
Prefix:
First Name:BRIANNA
Middle Name:ABIGAIL
Last Name:RICHARDS
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 1:2486 DORCHESTER RD
Mailing Address - Street 2:
Mailing Address - City:UNION
Mailing Address - State:NJ
Mailing Address - Zip Code:07083-5022
Mailing Address - Country:US
Mailing Address - Phone:908-887-4073
Mailing Address - Fax:
Practice Address - Street 1:1952 US HIGHWAY 22
Practice Address - Street 2:
Practice Address - City:BOUND BROOK
Practice Address - State:NJ
Practice Address - Zip Code:08805-1545
Practice Address - Country:US
Practice Address - Phone:908-967-6214
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-03-29
Last Update Date:2024-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician