Provider Demographics
NPI:1710536172
Name:VIENS, BRIANNA LYNN (MAC, LAC, LMT)
Entity Type:Individual
Prefix:
First Name:BRIANNA
Middle Name:LYNN
Last Name:VIENS
Suffix:
Gender:F
Credentials:MAC, LAC, LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6517 BELLEVIEW DR
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA
Mailing Address - State:MD
Mailing Address - Zip Code:21046-1016
Mailing Address - Country:US
Mailing Address - Phone:443-535-3317
Mailing Address - Fax:
Practice Address - Street 1:6517 BELLEVIEW DR
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:MD
Practice Address - Zip Code:21046-1016
Practice Address - Country:US
Practice Address - Phone:443-535-3317
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-09-09
Last Update Date:2019-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDU02668171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist